US20180353246A1 - Remote control apparatus for medical equipment - Google Patents
Remote control apparatus for medical equipment Download PDFInfo
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- US20180353246A1 US20180353246A1 US16/000,374 US201816000374A US2018353246A1 US 20180353246 A1 US20180353246 A1 US 20180353246A1 US 201816000374 A US201816000374 A US 201816000374A US 2018353246 A1 US2018353246 A1 US 2018353246A1
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- Prior art keywords
- display
- control apparatus
- remote control
- operator
- supporting arm
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/25—User interfaces for surgical systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B34/35—Surgical robots for telesurgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B34/37—Leader-follower robots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/74—Manipulators with manual electric input means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00212—Electrical control of surgical instruments using remote controls
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
- A61B2090/506—Supports for surgical instruments, e.g. articulated arms using a parallelogram linkage, e.g. panthograph
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
- A61B2090/508—Supports for surgical instruments, e.g. articulated arms with releasable brake mechanisms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/76—Manipulators having means for providing feel, e.g. force or tactile feedback
Definitions
- the disclosure relates to a remote control apparatus for medical equipment.
- Patent Literature 1 WO 2016/077552
- the position of the display is adjustable.
- the position of the display can be adjusted just in a simple manner, by separately controlling the height, depth, and angle thereof.
- the adjustable range of the position of the display is limited, so that the position of the display cannot be moved enough for the operator to change his/her posture.
- An object of an embodiment is to provide a remote control apparatus for medical equipment, which is able to easily change the position of a display and thereby allows an operator to freely take a desired posture even while viewing the display.
- An aspect of the disclosure is a remote control apparatus for a surgery assisting system including a manipulator that supports surgical equipment.
- the remote control apparatus includes: a display configured to display an image captured by an endoscopy; a display supporting arm that includes a joint and a locking mechanism and supports the display, the locking mechanism is configured to lock the joint; an operation handle that allows an operator to operate the manipulator; and an unlocking mechanism configured, in response to an operation by the operator, to unlock the locked joint of the display supporting arm.
- a second aspect of the disclosure is a remote control apparatus for a surgery assisting system including a manipulator that supports surgical equipment.
- the remote control apparatus includes: a display that displays an image captured by an endoscope; a display supporting arm that includes joints and locking mechanisms and supports the display, the joints including a first joint rotating around a horizontal axis and a second joint rotating around a horizontal axis, the locking mechanisms being disposed for the respective joints and locking the corresponding joints; an operation handle that allows the operator to operate the manipulator; and an unlocking mechanism configured, in response to an operation by the operator, to unlock the joints of the display supporting arm which are locked by the locking mechanisms.
- the unlocking mechanism that is being operated by the operator unlocks the joints locked by the locking mechanisms.
- the operator of the remote control apparatus can freely move the display to a desired position even during a surgery, for example.
- FIG. 1 is a schematic view illustrating a remote control apparatus according to one or more embodiments
- FIG. 2 is a perspective view illustrating the remote control apparatus according to a first embodiment
- FIG. 3 is a view illustrating a display supporting arm of the remote control apparatus
- FIG. 4 is a block diagram illustrating a control-related configuration of the remote control apparatus
- FIG. 5 is a side view illustrating a first configuration of the remote control apparatus
- FIG. 6 is a side view illustrating a second configuration of the remote control apparatus
- FIGS. 7A and 7B are views each illustrating a model of operators of the remote control apparatus
- FIGS. 8A to 8C are schematic views for explaining a first example of a display engaging mechanism and an unlocking mechanism of the remote control apparatus according to a first embodiment
- FIGS. 9A to 9C are schematic views for explaining a second example of the display engaging mechanism and unlocking mechanism of the remote control apparatus according to a first embodiment
- FIGS. 10A to 10C are schematic views for explaining a third example of the display engaging mechanism and unlocking mechanism of the remote control apparatus according to a first embodiment
- FIG. 11 is a perspective view illustrating a plane in a XYZ space by way of example.
- FIG. 12 is a perspective view illustrating a remote control apparatus according to a second embodiment.
- FIGS. 1 to 11 The configuration of a remote control apparatus 100 according to a first embodiment is described with reference to FIGS. 1 to 11 .
- the remote control apparatus 100 is provided for teleoperation of medical equipment included in a patient-side system 200 .
- an operator O as a surgeon, inputs an action mode instruction to be executed by the patient-side system 200
- the remote control apparatus 100 transmits the action mode instruction to the patient-side system 200 through a controller 206 .
- the patient-side system 200 operates medical equipment, such as surgical instruments and an endoscope, held by surgical manipulators 201 . This allows for minimally invasive surgery.
- a surgery assisting system includes the remote control apparatus 100 and the patient-side system 200 including the surgical manipulators 201 .
- the remote control apparatus 100 is an example of a remote control apparatus for medical equipment.
- the patient-side system 200 constitutes an interface to perform a surgery for a patient P.
- the patient-side system 200 is placed beside an operation table 300 on which the patient P lies.
- the patient-side system 200 includes plural surgical manipulators 201 .
- One of the surgical manipulators 201 holds an endoscope 201 b while the others hold surgical instruments (instruments 201 a ).
- the surgical manipulator 201 holding surgical instruments (instruments 201 a ) function as instrument arms 201 A while the surgical manipulator 201 holding the endoscope 201 b functions as a camera arm 201 B.
- the instrument arms 201 A and camera arm 201 B are commonly supported by a platform 203 .
- Each of the surgical manipulators 201 includes plural joints.
- Each joint includes a driver including a servo-motor and a position detector such as an encoder.
- the surgical manipulators 201 are configured so that medical equipment attached to each surgical manipulator 201 is controlled by a driving signal given through the controller 206 , to perform a desired movement.
- the platform 203 is supported by a positioner 202 placed on the floor of an operation room.
- the positioner 202 includes a column 204 and a base 205 .
- the column 204 includes an elevating shaft adjustable in the vertical direction.
- the base 205 includes wheels and is movable on the floor surface.
- the instrument arms 201 A detachably hold the instruments 201 a as the medical equipment at the tips thereof.
- Each instrument 201 a includes a housing and an end effector.
- the housing is attached to the instrument arm 201 A.
- the end effector is provided at the tip of an elongated shaft.
- the end effector is grasping forceps, a hook, scissors, a high-frequency knife, a snare wire, a clamp, or a stapler, for example.
- the end effector is not limited to those and can be various types of treatment tools.
- the instrument arms 201 A are introduced into the body of the patient P through a cannula (trocar) placed on the body surface of the patient P, and the end effector of each instrument 201 a is located near the surgery site.
- a cannula cannula
- the endoscope 201 b (see FIG. 4 ), as the medical equipment, is detachably attached.
- the endoscope 201 b captures an image within the body cavity of the patient P.
- the captured image is outputted to the remote control apparatus 100 .
- the endoscope 201 b is a 3D endoscope capable of capturing a three-dimensional image or a 2D endoscope.
- the camera arm 201 B is introduced into the body of the patient P through a trocar placed on the body surface of the patient P, and the endoscope 201 b is located near the surgery site.
- the endoscope 201 b is an example of an imaging section, or an imaging device.
- the remote control apparatus 100 constitutes the interface with the operator O.
- the remote control apparatus 100 is an apparatus that allows the operator O to operate medical equipment held by the surgical manipulators 201 .
- the remote control apparatus 100 is configured to transmit action mode instructions which are inputted by the operator O and are to be executed by the instruments 201 a and endoscope 201 b , to the patient-side system 200 through the controller 206 .
- the remote control apparatus 100 is installed beside the operation table 300 so that the operator O can see the state of the patient P very well while operating operation handles 1 , for example.
- the remote control apparatus 100 may be configured to transmit the action mode instructions wirelessly and installed in a room different from the operation room where the operation table 300 is installed.
- the action modes to be executed by the instruments 201 a include a mode of actions to be taken by each instrument 201 a (a series of positions and postures) and actions to be executed by the function of each instrument 201 a .
- the action mode to be executed by the instrument 201 a includes roll and pitch positions of the wrist of the end effector and the action to open or close the jaws.
- the action mode to be executed by the instrument 201 a includes vibration of the high-frequency knife, specifically, supply of current to the high-frequency knife.
- the action mode to be executed by the instrument 201 a includes a capturing action and an action to release the captured object and moreover includes an action to supply current to a bipolar or monopolar instrument to burn off the surgery site.
- the action mode to be executed by the endoscope 201 b includes the position and posture of the tip of the endoscope 201 b or setting of the zoom magnification, for example.
- the remote control apparatus 100 is provided with a cover 101 .
- the cover 101 covers the right and left sides of the remote control apparatus 100 (on X 1 and X 2 sides), the back side (on Y 2 side), and the top side (on the Z 1 side).
- FIGS. 2 to 11 illustrate the remote control apparatus 100 with the cover 101 removed for convenience.
- the remote control apparatus 100 includes operation handles 1 , an operation pedal section 2 , a display supporting arm 4 supporting a display 3 or a display device, an armrest 5 supporting the arms of the operator O, and a control apparatus 6 , and a base 7 .
- the remote control apparatus 100 further includes a positioning section 8 a , an operating section 8 b , and a supporting mechanism 9 .
- the supporting mechanism 9 supports the operation handles 1 and armrest 5 .
- the operation handles 1 are provided in order to remotely operate medical equipment held by the surgical manipulators 201 .
- the operation handles 1 accept operations by the operator O for operating medical equipment (the instruments 201 a and endoscope 201 b ).
- the operation handles 1 include a pair of operation handles 1 arranged side by side in the X direction.
- the right operation handle 1 (on the X 2 side) of the pair of operation handles 1 is operated by the right hand of the operator O while the left operation handle 1 (on the X 1 side) is operated by the left hand of the operator O.
- the operation handles 1 are attached to a supporting section 91 of the supporting mechanism 9 .
- the operation handles 1 extend from the back side (the Y 2 side) of the remote operation apparatus 100 toward the front side (the Y 1 side).
- Plural joints are provided between the supporting section 91 and each operation handle 1 so that the operation handles 1 move relative to the supporting section 91 in a predetermined three-dimensional operation range A (see FIGS. 5 and 6 ).
- the operation handles 1 are configured so as to move relative to the supporting section 91 , up and down (in the Z direction), right and left (in the X direction), and forward and backward (in the Y direction).
- Each joint between the supporting section 91 and operation handles 1 is provided with a not-illustrated position detector that detects the positional relationship between the joints.
- the position detector is an encoder, a resolver, or a potentiometer, for example. The position detector thereby detects the positions of the operation handles 1 relative to the supporting section 91 .
- the remote control apparatus 100 and patient-side system 200 constitute a master-slave system in terms of controlling motion of the instrument arms 201 A and camera arm 201 B.
- the operation handles 1 constitute an operating section on the master side in the master-slave system, and the instrument arms 201 A grasping medical equipment and the camera arm 201 B constitute an operating section on the slave side.
- the motion of the instrument arms 201 A or camera arm 201 B is controlled so that the tips (the end effectors of the instruments 201 a ) of the instrument arms 201 A and the tip (the endoscope 201 b ) of the camera arm 201 B move following the movement of the operation handles 1 .
- the patient-side system 200 controls the motion of the instrument arms 201 A in accordance with the set motion scaling ratio.
- the motion scaling ratio is set to 1 ⁇ 2, for example, the end effectors of the instruments 201 a move 1 ⁇ 2 of the movement distance of the operation handles 1 . This allows for precise fine surgery.
- the operation handles 1 are attached to the base 7 and extend toward the operator O in the Y direction.
- the operation pedal section 2 includes pedals operable by a foot of the operator O. Each pedal is assigned to a specific function. One of such functions is to input a switching instruction to change the target to be controlled by the operation handles 1 among the plural instrument arms 201 A and camera arm 201 B.
- the operator O operates the operation pedal section 2 for switching the target to be controlled by the operation handles 1 from the instrument arm 201 A to the camera arm 201 B and then operates the operation handles 1 to move the endoscope 201 b .
- the operator O operates the operation pedal section 2 to return the target to be controlled by the operation handles 1 from the camera arm 201 B to the instrument arm 201 A, continuing the surgery.
- the operation pedal section 2 is placed in lower part so as to be operable by feet.
- the operation pedal section 2 is movable in the Y direction.
- Another function of the operation pedal section 2 is to input an instruction to perform an action of the instrument 201 a attached to the tip of each instrument arm 201 A.
- the operation pedal section 2 is able to input an action to cause an instrument 201 a to cut or coagulate a surgery site. Operating the operation pedal section 2 applies voltage for cutting or voltage for coagulation to the instrument 201 a.
- the display 3 displays an image captured by the endoscope 201 b .
- the display 3 includes a scope type display 3 a or a non-scope type display 3 b (see FIG. 12 ).
- the scope type display 3 a is a display that the operator O looks into.
- the non-scope type display 3 b is a concept including an open-type display that the operator O looks at without looking into and that has a flat screen, such as a normal personal computer display.
- the scope and non-scope type displays 3 a and 3 b are selectively attachable to the remote control apparatus 100 .
- the scope type display 3 a is mounted on the remote control apparatus 100 . As illustrated in FIG.
- the scope type display 3 a includes a display 31 a , a grip section 32 , an attachment section 33 , a terminal 34 (see FIG. 4 ), and an angle adjustment joint 35 .
- the non-scope type display 3 b includes a display 31 b , a grip section 32 , an attachment section 33 , a terminal 34 (see FIG. 4 ), and an angle adjustment joint 35 as illustrated in FIG. 12 .
- the attachment section 33 of the scope and non-scope type display 3 a or 3 b is attachable to the mounting section 41 of the display supporting arm 4 of the remote control apparatus 100 .
- the scope or non-scope type display 3 a or 3 b mounted on the remote control apparatus 100 is configured to be supported by the display supporting arm 4 . This allows the remote control apparatus 100 to be used as either an immersive remote control apparatus or an open-type remote control apparatus.
- the remote control apparatus 100 is versatile in terms of the display 3 .
- the display of the remote control apparatus is versatile and expandable. If the display is broken or damaged, it is therefore only necessary to repair the display, and it is unnecessary to replace the entire apparatus. Moreover, the display can be upgraded without replacing the entire apparatus each time a higher definition or a higher quality display is developed. The operator can select a display of a favorite maker and favorite specifications (size, shape, type of operation panel, and the like).
- the terminal 34 includes a terminal capable of transmitting video, such as a serial digital interface (SDI) terminal, an analogue component terminal, a high-definition multimedia interface (HDMI, registered trademark) terminal, or a universal serial bus (USB) terminal.
- SDI serial digital interface
- HDMI high-definition multimedia interface
- USB universal serial bus
- the scope type display 3 a When the scope type display 3 a is mounted, 3D image captured by the endoscope 201 b held by the camera arm 201 B of the patient-side system 200 is displayed on the scope type display 3 a .
- the non-scope type display 3 b When the non-scope type display 3 b is mounted, 3D image captured by the endoscope 201 b provided to the patient-side system 200 is displayed on the non-scope type display 3 b .
- 2D image captured by the endoscope 201 b provided to the patient-side system 200 may be displayed on the non-scope type display 3 b.
- the scope type display 3 a is a viewer that the operator O looks into.
- the scope type display 3 a displays an image for the right eye of the operator O and an image for the left eye.
- the scope type display 3 a is a stereoscope, for example.
- the display 31 a includes a display for the right eye and a display for the left eye. When the operator O is looking into the display 31 a , the display for the right eye cannot seen by the left eye while the display for the left cannot be seen by the right eye.
- the display 31 a is composed of a liquid crystal display, an organic EL display, or the like.
- the display 31 a may be a projection-type display.
- the non-scope type display 3 b is an open-type display that the operator O is able to see without looking into and is a direct-view-type display.
- the display 31 b of the non-scope type display 3 b includes a flat or curved screen.
- the display 31 b can be a display with a diagonal of 10 to 90 inches, for example. Considering the balance between sufficient visibility of the surgical field and easy replacement, the display 31 b preferably has a diagonal of 15 to 30 inches.
- the display 31 b is composed of a liquid crystal display, an organic EL display, or the like.
- the display 31 b can be a projection-type display.
- the non-scope type display 3 b may employ a publicly-known stereoscopy in order for the operator O to stereoscopically view an image captured by the endoscope 201 b , such as a method using polarization glasses or a method using active shutter glasses.
- the grip section 32 is gripped when the display 3 is mounted, dismounted, or moved.
- the grip section 32 can be gripped with one hand.
- the grip section 32 has a grip, recessed, or protrusion shape.
- the grip section 32 is provided on a lateral side or back side of the display 3 so as not to interfere with viewing the display 31 a ( 31 b ).
- the grip section 32 can be gripped with one hand, and the grip section 32 may include plural grip sections 32 .
- the grip sections 32 may be provided on both sides of the display 3 as illustrated in FIG. 2 , for example, so that the operator O sitting in front of the display 3 can grip any grip section 32 with either right or left hand.
- Each grip section 32 includes a trigger lever 321 .
- the trigger lever 321 is an example of an unlocking mechanism.
- the attachment section 33 is attached to the mounting section 41 of the display supporting arm 4 .
- the mounting section 41 is detachably attached selectively to the scope or non-scope type display 3 a or 3 b , for example.
- the attachment section 33 includes an engagement section 331 as illustrated in a first example of FIGS. 8A to 8C .
- the mounting section 41 includes a release button 411 and an engagement section 412 .
- the engagement section 331 of the attachment section 33 is engaged with the engagement section 412 of the mounting section 41 , so that the attachment section 33 is locked with the mounting section 41 of the display supporting arm 4 .
- the display 3 is thereby fixed and supported by the display supporting arm 4 .
- the engagement sections 331 and 412 constitute a display engaging mechanism to fix the display 3 (the scope or non-scope type display 3 a or 3 b ).
- the release button 411 functions as a disengaging mechanism that releases the engagement by the display engaging mechanism composed of the engagement sections 331 and 412 .
- the disengaging mechanism is configured to release the engagement by the display engaging mechanism, with an action of force downward in the vertical direction. The disengaging mechanism thereby easily releases the engagement by the display engaging mechanism.
- the grip section 32 of the display 3 is operated upward in the vertical direction while the disengaging mechanism is acting downward in the vertical direction, so that the display 3 is dismounted from the remote control apparatus 100 .
- the display 3 is dismounted by performing the releasing operation downward in the vertical direction and the operation of raising the grip section upward in the vertical direction, that produce forces in the opposite directions.
- the display 3 is therefore dismounted stably and safely.
- the display 3 can be dismounted upward with space away from the display supporting arm 4 , not interfering with the operation handles 1 located underneath.
- the display engaging mechanism and disengaging mechanism may have another configuration and may be configured as illustrated in FIGS. 9A to 9C as a second example.
- the attachment section 33 includes an engagement section 332 as shown in FIGS. 9A to 9C .
- the mounting section 41 includes an engagement section 413 .
- the engagement section 332 of the attachment section 33 is engaged with the engagement section 413 of the mounting section 41 , so that the attachment section 33 is locked with the mounting section 41 of the display supporting arm 4 .
- the engagement section 332 sandwiches and grips the engagement section 413 .
- the display 3 is thereby fixed to and supported by the display supporting arm 4 .
- the engagement sections 332 and 413 constitute the display engaging mechanism to fix the display 3 (the scope or non-scope type display 3 a or 3 b ).
- the display engaging mechanism and release mechanism may have still another configuration as illustrated in FIGS. 10A to 10C as a third example.
- the attachment section 33 includes a notch 333 as shown in FIGS. 10A to 10C .
- the mounting section 41 includes a release button 414 , a fitting section 415 , and an engagement section 416 .
- the release button 414 is energized upward in the vertical direction by a spring or the like.
- the engagement section 416 is energized in a horizontal direction away from the fitting section 415 .
- the vertical movement of the release button 414 and the horizontal movement of the engagement section 416 work in conjunction with a gear and the like.
- the notch 333 of the attachment section 33 is engaged with the engagement section 416 of the mounting section 41 , so that the attachment section 33 is locked with the mounting section 41 of the display supporting arm 4 .
- the display 3 is thereby fixed to and supported by the display supporting arm 4 .
- the notch 333 and engagement section 416 constitute the display engaging mechanism to fix the display 3 (the scope or non-scope type display 3 a or 3 b ).
- the release button 414 functions as the disengaging mechanism to release the engagement by the display engaging mechanism composed of the notch 333 and engagement section 416 .
- the disengaging mechanism releases the engagement by the display engaging mechanism by an action of vertically downward force.
- the grip section 32 of the display 3 is operated upward in the vertical direction while the attachment section 33 is unlocked.
- the display 3 is thereby dismounted from the remote operation apparatus 100 .
- the engagement section 416 has a slope.
- the attachment section 33 When the attachment section 33 is pressed vertically downward against the mounting section 41 , the attachment section 33 comes into contact with the slope of the engagement section 416 and presses the engagement section 416 into the fitting section 415 in the horizontal direction.
- the attachment section 33 moves to a predetermined position, the engagement section 416 fits into the notch 333 and is locked in the fixed state.
- the display supporting arm 4 supports the display 3 as illustrated in FIG. 2 .
- the display supporting arm 4 includes the mounting section 41 , an arm section 42 , plural joints 43 , and a parallel link mechanism 44 .
- the mounting section 41 is provided at an end of the display supporting arm 4 .
- the other end thereof is supported by a column 45 .
- the column 45 is fixed to a supporting section 91 of the supporting mechanism 9 .
- the display 3 is thus supported by the supporting section 91 .
- the display supporting arm 4 is rotatable around rotation axes A 1 , A 2 , and A 3 , which extend vertically.
- the display supporting arm 4 is configured so that the mounting section 41 is moved up and down by the parallel link mechanism 44 .
- the mounting section 41 is thus supported with four degrees of freedom by the arm section 42 .
- the display supporting arm 4 includes joints 43 a , 43 b , and 43 c as the joints 43 .
- the joints 43 a to 43 c are respectively provided with electromagnetic brakes 431 a , 431 b , and 431 c as electromagnetic brakes 431 .
- the parallel link mechanism 44 includes an electromagnetic brake 441 a as an electromagnetic brake 441 .
- the joints 43 a to 43 c and parallel link mechanism 44 are examples of a joint, and the electromagnetic brakes 431 a to 431 c and 441 a are examples of a locking mechanism.
- the scope type display 3 a is attached to the display supporting arm 4 .
- the display supporting arm 4 supports the scope type display 3 a.
- the joint 43 a connects the mounting section 41 and a third link 48 so that the mounting section 41 and third link 48 rotate around the rotation axis A 3 .
- the joint 43 b connects a second link 47 and a first link 46 so that the second and first links 47 and 46 rotate around the rotation axis A 2 .
- the joint 43 c connects the first link 46 and column 45 so that the first link 46 and column 45 rotate around the rotation axis A 1 .
- the parallel link mechanism 44 connects the third and second links 48 and 47 so as to rotate in B 1 direction around a horizontal rotation axis orthogonal to the rotation axes A 1 to A 3 .
- the electromagnetic brakes 431 are configured to lock the joints 43 . Specifically, while not energized, each electromagnetic brake 431 presses at least one of two links connected at the corresponding rotation axis to prevent motion of the joint 43 into the locked state. While energized, magnetic force generated by the electromagnetic coil separates the electromagnetic brake 431 from the pressed link, thus unlocking the joint 43 .
- the electromagnetic brake 431 a presses the mounting section 41 at the rotation axis A 3 to lock the joint 43 a .
- the electromagnetic brake 431 b presses the second link 47 at the rotation axis A 2 to lock the joint 43 b .
- the electromagnetic brake 431 c presses the first link 46 at the rotation axis A 1 to lock the joint 43 c.
- the electromagnetic brake 441 a is configured to lock the parallel link mechanism 44 . Specifically, while not energized, the electromagnetic brake 441 a presses the parallel link mechanism 44 to lock the same. While energized, the electromagnetic brake 441 a unlocks the parallel link mechanism 44 .
- the grip section 32 of the display 3 is provided with the trigger lever 321 as the unlocking mechanism to release the lock of the electromagnetic brakes 431 and 441 .
- the trigger lever 321 is pressed down, the corresponding electromagnetic brake 431 or 441 is energized to release the lock.
- the trigger lever 321 is operated by the operator O to unlock the corresponding joint (at least one of the joints 43 a to 43 c and parallel link mechanism 44 ).
- the trigger lever 321 includes two trigger levers 321 disposed on the right and left sides of the display 3 by way of example. As illustrated in FIG. 2 , trigger levers 321 a are individually provided on the right and left side of the scope type display 3 a . As illustrated in FIG. 12 , trigger levers 321 b are individually provided on the right and left sides of the non-scope type display 3 b . Each trigger lever 321 is gripped with the grip section 32 (pressing operation) for the unlocking operation. When both of the right and left trigger levers 321 are pressed, all the joints (the joints 43 a to 43 c and parallel link mechanism 44 ) are unlocked.
- any joint is not unlocked.
- the joints cannot be unlocked even if one of the trigger levers 321 is touched and is pressed accidentally.
- the joints 43 and parallel link mechanism 44 are prevented from being unlocked accidentally.
- the display 3 Since the display 3 is supported by the display supporting arm 4 composed of plural joints and links as described above, the display 3 is adjustable in a wide range and can move to any place in a linear manner, compared with a mechanism just capable of adjusting the angle and the positions in the height and depth directions, of a display as described in Patent Literature 1.
- the display 3 is the scope type display 3 a , that the operator O looks into, the operator O can press the both right and left trigger levers 32 a and move the scope type display 3 a to a desired position while looking into the scope type display 3 a .
- the remote control apparatus 100 therefore allows the operator O to change his/her posture sensuously and quickly compared with the case where the operator checks the posture with his/her face affixed on the display 3 each time the operator separately sets the angle, height, and depth of the display 3 .
- this remote control apparatus 100 the operator can easily change the posture in a wide range of adjustment during long surgery. It is therefore possible to reduce the operator's feeling of fatigue and ill effects on the operator's health of remaining in the same posture.
- the display supporting arm 4 is placed on the opposite side of the display 3 from the operator O.
- the display supporting arm 4 is placed in the back side (on the Y 2 side) of the display 3 . This prevents the display supporting arm 4 and the operator O from interfering with each other, effectively increasing the freedom of movement of the display supporting arm 4 .
- the parallel link mechanism 44 includes the electromagnetic brake 441 , links 442 a and 442 b , pivots 443 a , 443 b , 443 c , and 443 d , a spring 444 , and a base section 445 as illustrated in FIG. 3 .
- the parallel link mechanism 44 is configured to translate the display 3 attached to the mounting section 41 up and down. In other words, the parallel link mechanism 44 is configured to move the display 3 up and down without changing the angle of the display screen of the display 3 .
- the link 442 a is rotatably connected to the pivots 443 a and 443 d .
- the link 442 b is rotatably connected to the pivots 443 b and 443 c .
- the links 442 a and 442 b are placed parallel to each other.
- the pivots 443 a and 443 b are disposed one above the other on a line parallel to the vertical direction with a predetermined interval therebetween.
- the pivots 443 c and 443 d are disposed one above the other on a line parallel to the vertical direction with a predetermined interval therebetween.
- the pivots 443 a to 443 d are thus located on vertices of a parallelogram.
- the line connecting the pivots 443 a and 443 b is parallel to the line connecting the pivots 443 d and 443 c .
- the line connecting the pivots 443 d and 443 c is therefore always parallel to the vertical direction.
- the electromagnetic brake 441 is attached to the pivot 443 a .
- the electromagnetic brake 441 presses the second link 47 and parallel link mechanism 44 to lock the rotation of the pivot 443 a .
- the rotation of the pivots 443 b to 443 d which are connected thereto by the links 442 a and 442 b , is also locked.
- the spring 444 is provided to press the base section 445 of the second link 47 .
- the base section 445 has a protruding bow-like shape.
- the end of the spring 444 on the second link 47 side presses the bow-like base section 445 , the end of the spring 444 tries to move upward along the bow-like base section 445 , generating a force to rotate upward the end of the parallel link mechanism 44 opposite to the second link 47 . Even if the display 3 needs to move against the gravity, therefore, the operator O is able to move upward easily.
- the angle adjustment joint 35 is provided between the display supporting arm 4 and display 3 separately from the joints 43 and parallel link mechanism 44 of the display supporting arm 4 .
- the angle adjustment joint 35 adjusts the angle of the display screen of the display 3 .
- the angle adjustment joint 35 includes an angle adjustment joint 35 a and an angle adjustment joint 35 b .
- the angle adjustment joint 35 a supports the scope type display 3 a so that the scope type display 3 a is rotatable in a direction C 1 (see FIG. 2 ).
- the angle adjustment joint 35 b supports the non-scope type display 3 b so that the non-scope type display 3 b is rotatable in a direction C 2 (see FIG. 12 ).
- the angle adjustment joint 35 is provided on the display 3 side when the display 3 is dismounted from the display supporting arm 4 .
- the angle of the display screen of the display 3 can be thereby changed independently. This facilitates adjustment of the angle of the display screen of the display 3 .
- the positioning of the display supporting arm 4 may be changed manually by the operator O or others or may be changed under movement control by a driver including a motor, a position detector, such as an encoder, and a brake.
- the display supporting arm 4 can be manually moved or electrically moved.
- the motor also operates following the motion of the display 3 manually operated, and the position of the display 3 can be stored by the position detector.
- motions may be instructed with a handheld or the like.
- the handheld may be provided with a release button to release the brake. Alternatively, the brake may be released automatically by operating a movement direction instruction button.
- the handheld may be composed of a remote controller including plural buttons or a teaching pendant, for example.
- the position of the display 3 (the positioning of the display supporting arm 4 ) may be stored for each surgeon.
- the position of the display 3 (the positioning of the display supporting arm 4 ) may be changed in cooperation with transition between the standing position and sitting position.
- the armrest 5 supports arms of the operator O.
- the armrest 5 includes an arm supporting section 51 and a pair of connecting sections 52 , and an operating section 53 .
- the arm supporting section 51 is located in front (on the Y 1 side) of the operation handles 1 and is configured to support the arms of the operator O. This stabilizes the arms of the operator O, so that the operator O can stably operate the operation handles 1 . Even when the end effectors need to be moved finely, the operator O performs stabilized operation with elbows and the like on the arm rest 5 . The operator O feels less strain even in long surgery.
- the arm supporting section 51 extends in the X direction.
- the pair of connecting sections 52 are provided to both ends of the arm supporting section 51 so as to sandwich the arm supporting section 51 in the X direction.
- the connecting sections 52 support the arm supporting section 51 .
- the connecting sections 52 extend in the Y direction.
- the end of each connecting section 52 on the Y 1 side is connected to the arm supporting section 51 .
- the ends of the connecting sections 52 on the Y 2 side are connected to the supporting section 91 of the supporting mechanism 9 .
- the armrest 5 is thus supported by the supporting mechanism 9 .
- the connecting sections 52 may be extended downward from the back side (the Y 2 side) to the front side (the Y 1 side).
- the connecting sections 52 may be extended upward from the back side (the Y 2 side) to the front side (the Y 1 side).
- the connecting sections 52 may be extended in the horizontal direction.
- the operating section 53 enables operation for settings of the remote control apparatus 100 .
- the operating section 53 enables operation for positioning the remote control apparatus 100 .
- the operating section 53 functions as the positioning section 8 a .
- the operating section 53 may function as the operating section 8 b .
- the operating section 53 includes a touch panel, for example.
- the control apparatus 6 includes a controller 61 , a storage 62 , and an image controller 63 , for example.
- the controller 61 includes a calculator such as a CPU.
- the storage 62 includes a memory, such as a ROM and a RAM.
- the control apparatus 6 may be composed of a single controller performing centralized control or may be composed of plural controllers that perform decentralized control in cooperation with each other.
- the controller 61 determines whether the action mode instruction inputted by the operation handles 1 is to be executed by the instruments 201 a or to be executed by the endoscope 201 b , depending on the state of the operation pedal section 2 .
- the controller 61 When determining that the action mode instruction inputted by the operation handles 1 is to be executed by the instruments 201 a , the controller 61 transmits the action mode instruction to the instrument arm 201 A.
- the instrument arms 201 A are thereby driven for control of motions of the instruments 201 a attached to the instrument arms 201 A.
- the controller 61 When determining that the action mode instruction inputted by the operation handles 1 is to be executed by the endoscope 201 b , the controller 61 transmits the action mode instruction to the camera arm 201 B.
- the camera arm 201 B is thereby driven for control of motions of the endoscope 201 b attached to the camera arm 201 B.
- the storage 62 stores control programs corresponding to the types of the instruments 201 a , for example.
- the controller 61 reads the stored control programs according to the types of the attached instruments 201 a .
- the action mode instructions from the operation handles 1 and/or the operation pedal section 2 of the remote control apparatus 100 thereby causes the respective instruments 201 a to perform proper motions.
- the image controller 63 transmits an image acquired by the endoscope 201 b to the terminal 34 of the display 3 .
- the image controller 63 modifies the image if necessary.
- the positioning section 8 a receives operations to move up and down the operation handles 1 , the display 3 supported by the display supporting arm 4 , and the arm rest 5 .
- the positioning section 8 a also receives operations to transform the remote control apparatus 100 between a first configuration and a second configuration.
- the positioning section 8 a is an operating section that receives a configuration change instruction to change the configuration of the remote control apparatus 100 to the standing position (the first configuration) or the sitting position (the second configuration).
- the positioning section 8 a includes plural operation buttons.
- the supporting mechanism 9 includes the supporting section 91 and the driver 92 .
- the supporting section 91 supports the operation handles 1 and armrest 5 .
- the supporting section 91 supports the display 3 through the display supporting arm 4 .
- the driver 92 is configured to move the supporting section 91 up and down.
- the driver 92 includes a motor and an encoder, for example, and moves the supporting section 91 up and down under control by the control apparatus 61 .
- the supporting mechanism 9 may allow the operator O or others to manually change the positioning.
- the driver 92 of the supporting mechanism 9 may be driven pneumatically or hydraulically.
- the armrest 5 may be rotated relative to the supporting mechanism 9 for adjustment of the position. For example, the armrest 5 may be rotated around the rotation axis along the X direction.
- the supporting mechanism 9 is configured to transition between a first mode and a second mode.
- the operation handles 1 which are positioned at a neutral position A 0 of the operation range A are placed and held at a height position H 1 , which is 85 cm or more above the floor surface on which the remote control apparatus 100 is installed, for example.
- the operation handles 1 which are positioned at the neutral position A 0 of the operation range A are placed and held at a height position H 2 , which is 48 cm or more below the height position H 1 .
- the operator O When the operation handles 1 which are positioned at the neutral position A 0 of the operation range A, are located at the height position H 1 (85 cm or more above the floor surface), the operator O is able to operate the operation handles 1 while standing up. When the operation handles 1 which are positioned at the neutral position A 0 of the operation range A are located at the height position H 2 (48 cm or more below the height position H 1 ), the operator O is able to operate the operation handles 1 while sitting down. The operator O is thus able to operate the remote control apparatus 100 in a desired posture. In addition, since the operation handles 1 are supported by the supporting mechanism 9 , the operator O does not need to support the operation handles 1 . This prevents an increase in strain on the operator O. The armrest 5 supporting the arms of the operator O further reduces the strain on the operator O and stabilizes the arms of the operator O. The operator O is therefore able to stably operate the operation handles 1 .
- the supporting mechanism 9 is configured to transition between the first mode (see FIG. 5 ), in which the operation handles 1 are held so that the operation range A of the operation handles 1 is within a clean area set at a predetermined height position or more above the floor surface on which the remote control apparatus 100 is installed, and the second mode (see FIG. 6 ), in which the operation handles 1 are held so that at least a part of the operation range A of the operation handles 1 is located below the clean area.
- clean technique In operation rooms, clean technique is used in order to prevent surgical incision sites and medical equipment from being contaminated by pathogen, foreign matters, or the like.
- a clean area and a contaminated area which is other than the clean area, are defined.
- the area from the floor surface to a certain height position H where foreign matters including dust and grit are more likely to remain is treated as the contaminated area in principle and is eliminated from the clean area.
- This area lies from the floor surface to a height position of about 70 cm, for example.
- the clean area is therefore set to a height position of 70 cm or more above the floor surface on which the remote control apparatus 100 is installed, for example.
- the operator O When the operation handles 1 are located so that the operation range A of the operation handles 1 is within the clean area set at the predetermined height or more above the floor surface, the operator O is able to operate the operation handles 1 while keeping his/her hands inside the clean area. If the operation handles 1 are cleaned, for example, the hands of the operator O is kept clean. When the operation handles 1 are held so that at least a part of the operation range A of the operation handles 1 is located below the clean area, the sitting operator O is able to operate the operation handles 1 at the low position. The operator O is thus able to operate the remote control apparatus 100 in a desired posture. In addition, the operation handles 1 are supported by the supporting mechanism 9 , and the operator O does not need to support the operation handles 1 . This can prevent an increase in strain on the operator O.
- the supporting mechanism 9 is also configured to allow for transition between the first mode (see FIG. 5 ), in which the operation handles 1 are held at the position suitable for the operator O to operate the operation handles 1 while standing up and the second mode (see FIG. 6 ) in which the operation handles 1 are held at the position suitable for the operator O to operate the operation handles 1 while sitting down.
- the remote operation apparatus 100 is set to the first mode, the operator O can operate the operation handles 1 while standing up.
- the remote operation apparatus 100 is set to the second mode, the operator O is able to operate the operation handles 1 while sitting down. The operator O is thus able to operate the remote control apparatus 100 in a desired posture.
- the operation handles 1 are supported by the supporting mechanism 9 , and the operator O does not need to support the operation handles 1 . This can reduce an increase in strain on the operator O.
- the supporting mechanism 9 is configured to move both the operation handles 1 and armrest 5 up and down at transition between the first and second modes. Specifically, the supporting mechanism 9 is configured to integrally move the operation handles 1 and armrest 5 up and down at transition between the first and second modes. This requires less components than that in the case where members for moving the operation handles 1 and armrest 5 up and down are separately provided. It is therefore possible to simplify the apparatus configuration and prevent an increase in size of the apparatus. In addition, the supporting mechanism 9 is configured to move the display 3 supported by the display supporting arm 4 up and down at transmission between the first and second modes. The supporting mechanism 9 thus integrally moves the operation handles 1 , armrest 5 , and display 3 up and down at transition between the first and second modes.
- the supporting mechanism 9 supports the display 3 that displays an image captured by the endoscope 201 b and supports the display 3 so that the position of the display 3 relative to the operation handles 1 is changeable in each of the first and second modes.
- the position of the display 3 is moved relative to the operation handles 1 by the display supporting arm 4 supported by the supporting mechanism 9 .
- the position of the display 3 relative to the operation handles 1 can be therefore changed according to the physique and posture of the operator O. This can increase the versatility of the display 3 .
- Operation for the patient-side system 200 by the operation handles 1 is disabled at transformation between the first and second modes.
- operation by the operation handles 1 is disabled, or transmission of action mode instructions is disabled.
- the control apparatus 61 does not transmit an action mode instruction to the patient-side system 200 even if the action mode instruction is transmitted from the operation handles 1 . This prevents the patient-side system 200 from working when the operation handles 1 are operated accidentally during transformation between the first and second modes.
- the operation handles 1 are positioned at a height suitable for the standing operator O to grip the operation handles 1 positioned at the neutral position A 0 with the arms bent at substantially right angles.
- the display 3 is positioned at a height suitable for the standing operator O to look at the display 3 .
- the scope type display 3 a is mounted, for example, the scope type display 3 a is set at the same height as the eyes of the operator O.
- the operation range A of the operation handles 1 is fully within the clean area 70 cm or more above the floor surface in the standing position mode (the first configuration) by designing based on a human model for ergonomics.
- the operation pedal section 2 When the remote control apparatus 100 is in the standing position (the first configuration), the operation pedal section 2 is moved to a position P 1 in the front side (in the Y 1 side) of the remote control apparatus 100 . In other words, the operation pedal section 2 is located to such a position that the standing operator O reaches the operation pedal section 2 with his/her foot while touching the operation handles 1 with his/her hands.
- the remote control apparatus 100 when the remote control apparatus 100 is in the sitting position (the second configuration).
- the operation handles 1 are positioned at a height suitable for the operator O sitting in the chair to grip the operation handles 1 positioned at the neutral position A 0 with his/her arms bent at substantially right angles.
- the display 3 is positioned at a height position suitable for the operator O sitting in the chair to look at the display 3 .
- the scope type display 3 a When the scope type display 3 a is mounted, for example, the scope type display 3 a is set at the same height as the eyes of the operator O.
- the operation pedal section 2 When the remote control apparatus 100 is in the sitting position (the second configuration), the operation pedal section 2 is located to a position P 2 in the back side (in the Y 2 e side) of the remote control apparatus 100 . In other words, the operation pedal section 2 is located to such a position that the sitting operator O reaches the operation pedal section 2 with his/her feet while touching the operation handles 1 with his/her hands.
- the operation pedal section 2 is movable forward and backward by 300 mm or more (in the Y direction), for example.
- the operation pedal section 2 is movable forward and backward by 350 mm or more (in the Y direction).
- the operation pedal section 2 can be therefore easily located to the positions suitable for the first and second configurations.
- the remote control apparatus 100 may be designed with reference to JIS standards.
- Ergonomic design of control centres Part 4: Layout and dimensions of workstations
- the operation range A is defined as a region between 15 cm above and below the neutral position A 0 .
- the dimension of the operation range A in the height direction is defined as 30 cm.
- the operation range A is defined based on the dimensions of the motion range of surgical tools set to keep good operability of the surgical tools at laparoscopic surgery and the motion scaling ratio of the operation handles 1 .
- the set motion range of the surgical tools has a dimension of 30 cm in the height direction, and the motion scaling ratio of the operation handles 1 is 1 ⁇ 2.
- the dimension of the operation range A in the height direction is therefore 30 cm based on the dimension of the motion range of the surgical tools in the height direction and the motion scaling ratio of the operation handles 1 .
- FIGS. 7A and 7B are views illustrating models of operators O, FIG. 7A illustrating a model of large operators O 1 , and FIG. 7B illustrating a model of small operators O 2 .
- the model of the large operators O 1 is based on body data of German men.
- the fifth largest model among 100 German male models selected at random stands and grips the operation handles 1 positioned at the neutral position A 0 of the operation range A with his arms bent at right angles, the height position of the operation handles 1 is about 1176 mm, and the lower and upper limits of the height position of the operation range A are about 1026 mm and 1326 mm, respectively.
- the height position of the operation handles 1 is about 703 mm, and the lower and upper limits of the height position of the operation range A are about 553 mm and about 853 mm, respectively.
- the model of the small operators O 2 is based on body data of Japanese women.
- the fifth smallest model among 100 Japanese female models selected at random stands and grips the operation handles 1 positioned at the neutral position A 0 of the operation range A with her arms bent at right angles
- the height position of the operation handles 1 is about 992 mm
- the lower and upper limits of the height position of the operation range A are about 842 mm and about 1142 mm, respectively.
- the height position of the operation handles 1 is about 643 mm, and the lower and upper limits of the height position of the operation range A are about 493 mm and about 793 mm, respectively.
- the height position of the operation handles 1 that allows plural operators O having different types of physique to take standing and sitting positions without any problem is as follows.
- the height position of the operation handles 1 positioned at the neutral position A 0 of the operation range A in the standing position mode (the first mode) is preferably set to about 99 cm or more corresponding to the standing model of the small operators O 2 . This allows most operators O to comfortably operate the operation handles 1 while standing.
- the lower limit of the height position of the operation range A of the operation handles 1 in the standing position mode is 84 cm or more as described above.
- the height position of the operation handles 1 positioned at the neutral position A 0 in the standing position mode is preferably set to about 85 cm or more.
- the lower limit of the height position of the operation range A of the operation handles 1 in the standing position mode is higher than 70 cm, and the operation range A of the operation handles 1 is therefore within the clean area. Since the lower limit of the height position of the operation range A corresponding to the standing model of the small operators O 2 is about 84 cm, setting the lower limit of the height position of the operation range A to 70 cm allows more operators O having different types of physiques to comfortably operate the operation handles 1 while standing up.
- the height position of the operation handles 1 positioned at the neutral position A 0 of the operation range A in the sitting position mode is preferably set to about 64 cm or more corresponding to the sitting model of the small operators O 2 . This allows most operators O to comfortably operate the operation handles 1 while sitting down.
- the displacement (adjustment width) of the height position of the operation handles 1 at transition of the remote control apparatus 100 between the standing position mode and the sitting position mode is preferably set to about 35 cm or more. This is the difference between the height (about 99 cm) of the operation handles 1 positioned at the neutral position A 0 corresponding to the standing model of the small operators O 2 and the height (about 64 cm) of the operation handles 1 positioned at the neutral position A 0 corresponding to the sitting model of the small operators O 2 .
- the displacement of the height position of the operation handles 1 at transition of the remote control apparatus 100 between the standing position mode and the sitting position mode is preferably set to about 48 cm or more. This is the difference between the height (about 118 cm, the maximum height of the operation handles 1 positioned at the neutral position A 0 in the standing position mode in this example) of the operation handles 1 positioned at the neutral position A 0 corresponding to the standing model of the large operators O 1 and the height (about 70 cm) of the operation handles 1 positioned at the neutral position A 0 corresponding to the sitting model of the large operators O 1 .
- the adjustment width of the height position of the operation handles 1 at transition between the standing position mode and the sitting position mode is greater than the adjustment width desirably set so as to fit to the different types of physique of the operators O in the standing position mode (about 19 cm as the difference between the height position of the operation handles 1 positioned at the neutral position A 0 , corresponding to the model of the large operators O 1 and the height position of the operation handles 1 positioned at the neutral position A 0 , corresponding to the model of the small operators O 2 , for example) and the adjustment width desirably set so as to fit to the different types of physique of the operators O in the sitting position mode (about 6 cm as the difference between the height position of the operation handles 1 positioned at the neutral position A 0 corresponding to the model of the large operators O 1 and the height position of the operation handles 1 positioned at the neutral position A 0 corresponding to the model of the small operators O 2 , for example).
- the positions of the operation handles 1 are set higher than about 118 cm (the height position of the operation handles 1 positioned at the neutral position A 0 corresponding to the standing model of the large operators O 1 ), the above-described adjustment width is further increased. It is then preferable that the adjustment width is 50 cm or more from the height position of the operation handles 1 in the standing position mode.
- the displacement of the height position of the operation handles 1 at transition of the remote control apparatus 100 between the standing position mode and the sitting position mode is preferably set to about 54 cm or more, which is the difference between the height (about 118 cm) of the operation handles 1 positioned at the neutral position A 0 corresponding to the standing model of the large operators O 1 and the height (about 64 cm) of the operation handles 1 positioned at the neutral position A 0 corresponding to the sitting model of the small operators O 2 .
- the design of the operation range A may be modified by considering the size of the operation handles 1 and the like.
- the vertical width of the operation range A is assumed to be 30 cm, the vertical width thereof may be set to 20, 25, or 35 cm, for example.
- a remote control apparatus 400 includes plural display supporting arms 4 .
- the display supporting arms 4 include display supporting arms 4 a and 4 b .
- the scope type display 3 a and non-scope type display 3 b as the displays 3 are attached to the display supporting arms 4 a and 4 b of the remote control apparatus 400 , respectively.
- the two displays 3 are placed right and left (side by side in the X direction).
- the display supporting arms 4 a and 4 b are examples of a first display supporting arm and a second display supporting arm, respectively.
- the remote control apparatus 400 includes plural (two) mounting sections 41 .
- the remote control apparatus 400 includes the two display supporting arms 4 ( 4 a , 4 b ).
- the mounting sections 41 are provided to the respective tips of the display supporting arms 4 a and 4 b .
- Both of the scope and non-scope type displays 3 a and 3 b can be thereby mounted on the remote control apparatus 400 . This effectively increases the versatility of the displays 3 .
- the non-scope type display 3 b which is one of the displays 3 , displays at least one of a previously acquired image of the surgical site, information indicating the state of the surgery, and operation information.
- the non-scope type display 3 b displays X-ray images or magnetic resonance images previously captured.
- the other scope type or non-scope type displays a 3D or 2D image acquired from the endoscope 201 b . This further increases the versatility and expandability such that, for example, the operator O performs surgery by mainly looking at the endoscopic image on the other display, while viewing, as needed, at least one kind of auxiliary information among the image of the surgery site previously acquired, the information indicating the state of the surgery, and the operation information.
- the remote control apparatus 400 is configured so that the scope or non-scope type display 3 a or 3 b is selectively mounted as the main display 3 .
- the non-scope type display 3 b is mounted on the remote control apparatus 400 as an auxiliary display.
- the operator O can therefore select one of the immersive remote control apparatus and the open-type remote control apparatus and look at the auxiliary information during surgery. Since the remote control apparatus 400 is provided with plural mounting sections, it is possible to freely select on which side the main display is installed.
- the display supporting arm 4 a includes joints 43 a , 43 b , and 43 c as the joints 43 .
- the display supporting arm 4 a includes a parallel link mechanism 44 a as the parallel link mechanism 44 .
- the joints 43 a to 43 c are respectively provided with electromagnetic brakes 431 a , 431 b , and 431 c as electromagnetic brakes 431 .
- the parallel link mechanism 44 a is provided with an electromagnetic brake 441 a as the electromagnetic brake 441 .
- the joints 43 a to 43 c and parallel link mechanism 44 a are examples of a joint and a first joint, respectively, and the electromagnetic brakes 431 a to 431 c and 441 a are examples of a locking mechanism and a first locking mechanism, respectively.
- the display supporting arm 4 b includes joints 43 d , 43 e , and 43 f as the joints 43 .
- the display supporting arm 4 b includes a parallel link mechanism 44 b as the parallel link mechanism 44 .
- the joints 43 d to 43 f are respectively provided with electromagnetic brakes 431 d , 431 e , and 431 f as electromagnetic brakes 431 as illustrated in FIG. 3 .
- the parallel link mechanism 44 b is provided with an electromagnetic brake 441 b as the electromagnetic brakes 441 .
- the joints 43 d to 43 f and parallel link mechanism 44 b are examples of a joint and a second joint, respectively, and the electromagnetic brakes 431 d to 431 f and 441 b are examples of a locking mechanism and a second locking mechanism, respectively.
- the trigger levers 321 a are provided on the right and left sides of the scope type display 3 a .
- the trigger levers 321 b are provided on the right and left sides of the non-scope type display 3 b .
- the trigger levers 321 are gripped together with respective grip sections 32 for unlocking operation.
- the trigger levers 321 a are configured to unlock the electromagnetic brakes 431 a to 431 c and 441 a of the display supporting arm 4 a .
- the trigger levers 321 b are configured to unlock the electromagnetic brakes 431 d to 431 f of the display supporting arm 4 b .
- the joints 43 a to 43 c and the parallel link mechanism 44 a of the display supporting arm 4 a and the joints 43 d to 43 f and the parallel link mechanism 44 b of the display supporting arm 4 b can be therefore unlocked independently of each other.
- the trigger levers 321 a and 321 b are examples of a first unlocking mechanism and a second unlocking mechanism.
- the scope type display 3 a and non-scope type display 3 b are attached to the two mounting sections 41 .
- the scope type display 3 a may be attached to each of the two mounting sections 41
- the non-scope type display 3 b may be attached to each of the two mounting sections 41 .
- the joints (the joints 43 a to 43 c and the parallel link mechanism 44 ) are unlocked by pressing both of the two trigger levers 321 on the right and left sides of the display 3 .
- the way of unlocking the locking mechanisms of the joints is not limited to these examples.
- the unlocking mechanism may be configured so that all the joints are unlocked with only one of the two trigger levers 321 on the right and left sides of the display 3 .
- the operator O is able to move the display 3 with one hand.
- the operator O therefore moves the display 3 more easily.
- the operator O is able to change the position of the display 3 with one hand regardless of whether the operator O is right-handed or left-handed.
- the display 3 may be provided with only one trigger lever 321 .
- Such a configuration includes fewer physical mechanisms around the display 3 , reducing interferences with other portions.
- a display for left-handed operators or a display for right-handed operators may be provided as needed for use.
- the remote control apparatus 100 includes a mounting section to which the display 3 is detachably attached, it is possible to select and use one from a display for right-handed operators and a display for left-handed operators as needed.
- the display 3 may be provided with three or more trigger levers 321 .
- the trigger levers 321 are provided on the right and left sides of the display 3 while one trigger lever 321 is provided as one of the foot pedals, and the display 3 is configured to move only when the three trigger levers 321 are pressed. In this case, the position of the display 3 cannot be changed until the operator O absolutely intends to move the position of the display 3 .
- each trigger lever 321 may be configured to unlock different joints.
- one of the right and left trigger levers 321 may be configured to unlock at least one (only the joint 43 a , for example) of the joints contributing to horizontal movement of the display 3 while the other trigger lever 321 is configured to unlock at least one (the parallel link mechanism 44 in the example of FIG. 3 ) of the joints contributing to vertical movement of the display 3 .
- movement of the display 3 may be limited so that the display 3 mainly moves in a desired direction.
- Such a configuration moreover allows only necessary joints to be movable, reducing burden on the display supporting arm 4 in the process of moving the display 3 .
- each joint of the display supporting arm 4 includes a motor and a position detector (an encoder, for example), the range of movement of the display 3 can be limited.
- the display 3 is translated along a certain plane.
- the control apparatus 61 may perform a control so as to translate the display 3 along only the plane PL.
- the plane PL may be determined by the state of the angle adjustment joints 35 , for example.
- the plane PL may be defined by the operation section 8 b . To be specific, the angle of the plane PL along which the display 3 is translated may be inputted from the operation section 8 b.
- the controller 61 may perform a control so that each joint is not unlocked while the operation handles 1 are being operated even if the pressing operation for the trigger levers 321 is detected. Whether the operation handles 1 are being operated can be detected with a motion sensor, for example. It is therefore possible to prohibit operating the operation handles 1 with one hand while operating the trigger lever 321 with the other hand, improving the safety as medical equipment.
- the operation section 8 b (see FIG. 4 ) is configured to set which to use among the above-described variations of the unlocking mechanism, that is, the condition to deactivate the locking mechanism of the joints by the trigger levers 321 as the unlocking mechanism.
- the conditions are set as follows.
- the aforementioned first embodiment discloses an example(s) of the configuration in which one display supporting arm supporting the display is provided.
- the aforementioned second embodiment discloses an example(s) of the configuration in which two display supporting arms supporting the displays are provided.
- the invention is not limited to this example.
- the remote control apparatus may be provided with three or more display supporting arms supporting displays, or the remote control apparatus may be provided with three or more displays.
- each display supporting arm includes plural joints.
- the invention is not limited to this example.
- the display supporting arm may include only one joint.
- the aforementioned first and second embodiments disclose examples of the configurations in which the displays are detachably attached to the display supporting arms.
- the invention is not limited to these examples.
- the display may be fixed to the display supporting arm.
- the aforementioned second embodiment disclose examples of the configurations in which the remote control apparatus is provided with the scope and non-scope type displays.
- the invention is not limited to these examples.
- the remote control apparatus may be provided with only one scope type display or may be provided with only one non-scope type display.
- the aforementioned first and second embodiments disclose examples of the configurations in which the mounted display is connected to the remote control apparatus with a cable so as to exchange information with the same.
- the invention is not limited to these examples.
- the mounted display may be connected to the remote control apparatus through wireless communication so as to exchange information.
- the aforementioned first and second embodiments disclose examples of the configuration in which the supporting mechanism moves the operation handles and armrest up and down.
- the invention is not limited to these examples.
- the supporting mechanism may move the operation handles and armrest in the horizontal direction in addition to up and down movements.
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Abstract
Description
- This application claims priority based on 35 USC 119 from prior Japanese Patent Applications No. 2017-113345 filed on Jun. 8, 2017, entitled “REMOTE CONTROL APPARATUS FOR MEDICAL EQUIPMENT”, the entire contents of which are incorporated herein by reference.
- The disclosure relates to a remote control apparatus for medical equipment.
- In recent years, surgical robots have been used in various surgeries, and remote control apparatuses for surgical robots are expected to improve in operability. In order to improve the operator's immersive feeling to surgeries, most conventional remote control apparatuses are provided with a viewer that the operator looks into with his/her face affixed thereon, as described in Patent Literature 1.
- Patent Literature 1: WO 2016/077552
- In the remote control apparatus of Patent Literature 1, the position of the display is adjustable. However, the position of the display can be adjusted just in a simple manner, by separately controlling the height, depth, and angle thereof. In addition, the adjustable range of the position of the display is limited, so that the position of the display cannot be moved enough for the operator to change his/her posture.
- An object of an embodiment is to provide a remote control apparatus for medical equipment, which is able to easily change the position of a display and thereby allows an operator to freely take a desired posture even while viewing the display.
- An aspect of the disclosure is a remote control apparatus for a surgery assisting system including a manipulator that supports surgical equipment. The remote control apparatus includes: a display configured to display an image captured by an endoscopy; a display supporting arm that includes a joint and a locking mechanism and supports the display, the locking mechanism is configured to lock the joint; an operation handle that allows an operator to operate the manipulator; and an unlocking mechanism configured, in response to an operation by the operator, to unlock the locked joint of the display supporting arm.
- A second aspect of the disclosure is a remote control apparatus for a surgery assisting system including a manipulator that supports surgical equipment. The remote control apparatus according to the second aspect includes: a display that displays an image captured by an endoscope; a display supporting arm that includes joints and locking mechanisms and supports the display, the joints including a first joint rotating around a horizontal axis and a second joint rotating around a horizontal axis, the locking mechanisms being disposed for the respective joints and locking the corresponding joints; an operation handle that allows the operator to operate the manipulator; and an unlocking mechanism configured, in response to an operation by the operator, to unlock the joints of the display supporting arm which are locked by the locking mechanisms. The unlocking mechanism that is being operated by the operator unlocks the joints locked by the locking mechanisms.
- According to at least one of the aspects, the operator of the remote control apparatus can freely move the display to a desired position even during a surgery, for example.
-
FIG. 1 is a schematic view illustrating a remote control apparatus according to one or more embodiments; -
FIG. 2 is a perspective view illustrating the remote control apparatus according to a first embodiment; -
FIG. 3 is a view illustrating a display supporting arm of the remote control apparatus; -
FIG. 4 is a block diagram illustrating a control-related configuration of the remote control apparatus; -
FIG. 5 is a side view illustrating a first configuration of the remote control apparatus; -
FIG. 6 is a side view illustrating a second configuration of the remote control apparatus; -
FIGS. 7A and 7B are views each illustrating a model of operators of the remote control apparatus; -
FIGS. 8A to 8C are schematic views for explaining a first example of a display engaging mechanism and an unlocking mechanism of the remote control apparatus according to a first embodiment; -
FIGS. 9A to 9C are schematic views for explaining a second example of the display engaging mechanism and unlocking mechanism of the remote control apparatus according to a first embodiment; -
FIGS. 10A to 10C are schematic views for explaining a third example of the display engaging mechanism and unlocking mechanism of the remote control apparatus according to a first embodiment; -
FIG. 11 is a perspective view illustrating a plane in a XYZ space by way of example; and -
FIG. 12 is a perspective view illustrating a remote control apparatus according to a second embodiment. - Embodiments are explained with reference to drawings hereinafter.
- The configuration of a
remote control apparatus 100 according to a first embodiment is described with reference toFIGS. 1 to 11 . - As illustrated in
FIG. 1 , theremote control apparatus 100 is provided for teleoperation of medical equipment included in a patient-side system 200. When an operator O, as a surgeon, inputs an action mode instruction to be executed by the patient-side system 200, to theremote control apparatus 100, theremote control apparatus 100 transmits the action mode instruction to the patient-side system 200 through acontroller 206. In response to the action mode instruction transmitted from theremote control apparatus 100, the patient-side system 200 operates medical equipment, such as surgical instruments and an endoscope, held bysurgical manipulators 201. This allows for minimally invasive surgery. A surgery assisting system includes theremote control apparatus 100 and the patient-side system 200 including thesurgical manipulators 201. Theremote control apparatus 100 is an example of a remote control apparatus for medical equipment. - The patient-side system 200 constitutes an interface to perform a surgery for a patient P. The patient-side system 200 is placed beside an operation table 300 on which the patient P lies. The patient-side system 200 includes plural
surgical manipulators 201. One of thesurgical manipulators 201 holds anendoscope 201 b while the others hold surgical instruments (instruments 201 a). Thesurgical manipulator 201 holding surgical instruments (instruments 201 a) function asinstrument arms 201A while thesurgical manipulator 201 holding theendoscope 201 b functions as a camera arm 201B. Theinstrument arms 201A and camera arm 201B are commonly supported by aplatform 203. Each of thesurgical manipulators 201 includes plural joints. Each joint includes a driver including a servo-motor and a position detector such as an encoder. Thesurgical manipulators 201 are configured so that medical equipment attached to eachsurgical manipulator 201 is controlled by a driving signal given through thecontroller 206, to perform a desired movement. - The
platform 203 is supported by apositioner 202 placed on the floor of an operation room. Thepositioner 202 includes acolumn 204 and abase 205. Thecolumn 204 includes an elevating shaft adjustable in the vertical direction. Thebase 205 includes wheels and is movable on the floor surface. - The
instrument arms 201A detachably hold theinstruments 201 a as the medical equipment at the tips thereof. Eachinstrument 201 a includes a housing and an end effector. The housing is attached to theinstrument arm 201A. The end effector is provided at the tip of an elongated shaft. The end effector is grasping forceps, a hook, scissors, a high-frequency knife, a snare wire, a clamp, or a stapler, for example. The end effector is not limited to those and can be various types of treatment tools. In surgeries using the patient-side system 200, theinstrument arms 201A are introduced into the body of the patient P through a cannula (trocar) placed on the body surface of the patient P, and the end effector of eachinstrument 201 a is located near the surgery site. - To the tip of the camera arm 201B, the
endoscope 201 b (seeFIG. 4 ), as the medical equipment, is detachably attached. Theendoscope 201 b captures an image within the body cavity of the patient P. The captured image is outputted to theremote control apparatus 100. Theendoscope 201 b is a 3D endoscope capable of capturing a three-dimensional image or a 2D endoscope. In surgeries using the patient-side system 200, the camera arm 201B is introduced into the body of the patient P through a trocar placed on the body surface of the patient P, and theendoscope 201 b is located near the surgery site. Theendoscope 201 b is an example of an imaging section, or an imaging device. - The
remote control apparatus 100 constitutes the interface with the operator O. Theremote control apparatus 100 is an apparatus that allows the operator O to operate medical equipment held by thesurgical manipulators 201. Specifically, theremote control apparatus 100 is configured to transmit action mode instructions which are inputted by the operator O and are to be executed by theinstruments 201 a andendoscope 201 b, to the patient-side system 200 through thecontroller 206. Theremote control apparatus 100 is installed beside the operation table 300 so that the operator O can see the state of the patient P very well while operating operation handles 1, for example. Theremote control apparatus 100 may be configured to transmit the action mode instructions wirelessly and installed in a room different from the operation room where the operation table 300 is installed. - The action modes to be executed by the
instruments 201 a include a mode of actions to be taken by eachinstrument 201 a (a series of positions and postures) and actions to be executed by the function of eachinstrument 201 a. For theinstrument 201 a which is a pair of grasping forceps, for example, the action mode to be executed by theinstrument 201 a includes roll and pitch positions of the wrist of the end effector and the action to open or close the jaws. For theinstrument 201 a which is a high-frequency knife, the action mode to be executed by theinstrument 201 a includes vibration of the high-frequency knife, specifically, supply of current to the high-frequency knife. For theinstrument 201 a which is a snare wire, the action mode to be executed by theinstrument 201 a includes a capturing action and an action to release the captured object and moreover includes an action to supply current to a bipolar or monopolar instrument to burn off the surgery site. - The action mode to be executed by the
endoscope 201 b includes the position and posture of the tip of theendoscope 201 b or setting of the zoom magnification, for example. - As illustrated in
FIG. 1 , theremote control apparatus 100 is provided with acover 101. Thecover 101 covers the right and left sides of the remote control apparatus 100 (on X1 and X2 sides), the back side (on Y2 side), and the top side (on the Z1 side).FIGS. 2 to 11 illustrate theremote control apparatus 100 with thecover 101 removed for convenience. - As illustrated in
FIGS. 2 and 4 , theremote control apparatus 100 includes operation handles 1, anoperation pedal section 2, adisplay supporting arm 4 supporting adisplay 3 or a display device, anarmrest 5 supporting the arms of the operator O, and a control apparatus 6, and abase 7. Theremote control apparatus 100 further includes apositioning section 8 a, anoperating section 8 b, and a supportingmechanism 9. The supportingmechanism 9 supports the operation handles 1 andarmrest 5. - The operation handles 1 are provided in order to remotely operate medical equipment held by the
surgical manipulators 201. Specifically, the operation handles 1 accept operations by the operator O for operating medical equipment (theinstruments 201 a andendoscope 201 b). The operation handles 1 include a pair of operation handles 1 arranged side by side in the X direction. The right operation handle 1 (on the X2 side) of the pair of operation handles 1 is operated by the right hand of the operator O while the left operation handle 1 (on the X1 side) is operated by the left hand of the operator O. - The operation handles 1 are attached to a supporting
section 91 of the supportingmechanism 9. The operation handles 1 extend from the back side (the Y2 side) of theremote operation apparatus 100 toward the front side (the Y1 side). Plural joints are provided between the supportingsection 91 and each operation handle 1 so that the operation handles 1 move relative to the supportingsection 91 in a predetermined three-dimensional operation range A (seeFIGS. 5 and 6 ). Specifically, the operation handles 1 are configured so as to move relative to the supportingsection 91, up and down (in the Z direction), right and left (in the X direction), and forward and backward (in the Y direction). Each joint between the supportingsection 91 and operation handles 1 is provided with a not-illustrated position detector that detects the positional relationship between the joints. The position detector is an encoder, a resolver, or a potentiometer, for example. The position detector thereby detects the positions of the operation handles 1 relative to the supportingsection 91. - The
remote control apparatus 100 and patient-side system 200 constitute a master-slave system in terms of controlling motion of theinstrument arms 201A and camera arm 201B. The operation handles 1 constitute an operating section on the master side in the master-slave system, and theinstrument arms 201A grasping medical equipment and the camera arm 201B constitute an operating section on the slave side. When the operator O operates the operation handles 1, the motion of theinstrument arms 201A or camera arm 201B is controlled so that the tips (the end effectors of theinstruments 201 a) of theinstrument arms 201A and the tip (theendoscope 201 b) of the camera arm 201B move following the movement of the operation handles 1. - The patient-side system 200 controls the motion of the
instrument arms 201A in accordance with the set motion scaling ratio. When the motion scaling ratio is set to ½, for example, the end effectors of theinstruments 201 a move ½ of the movement distance of the operation handles 1. This allows for precise fine surgery. The operation handles 1 are attached to thebase 7 and extend toward the operator O in the Y direction. - The
operation pedal section 2 includes pedals operable by a foot of the operator O. Each pedal is assigned to a specific function. One of such functions is to input a switching instruction to change the target to be controlled by the operation handles 1 among theplural instrument arms 201A and camera arm 201B. In order to change the field of view during surgery, the operator O operates theoperation pedal section 2 for switching the target to be controlled by the operation handles 1 from theinstrument arm 201A to the camera arm 201B and then operates the operation handles 1 to move theendoscope 201 b. After moving theendoscope 201 b, the operator O operates theoperation pedal section 2 to return the target to be controlled by the operation handles 1 from the camera arm 201B to theinstrument arm 201A, continuing the surgery. Theoperation pedal section 2 is placed in lower part so as to be operable by feet. Theoperation pedal section 2 is movable in the Y direction. - Another function of the
operation pedal section 2 is to input an instruction to perform an action of theinstrument 201 a attached to the tip of eachinstrument arm 201A. Theoperation pedal section 2 is able to input an action to cause aninstrument 201 a to cut or coagulate a surgery site. Operating theoperation pedal section 2 applies voltage for cutting or voltage for coagulation to theinstrument 201 a. - The
display 3 displays an image captured by theendoscope 201 b. Thedisplay 3 includes ascope type display 3 a or a non-scope type display 3 b (seeFIG. 12 ). Thescope type display 3 a is a display that the operator O looks into. The non-scope type display 3 b is a concept including an open-type display that the operator O looks at without looking into and that has a flat screen, such as a normal personal computer display. The scope and non-scope type displays 3 a and 3 b are selectively attachable to theremote control apparatus 100. In the example illustrated inFIG. 2 , thescope type display 3 a is mounted on theremote control apparatus 100. As illustrated inFIG. 2 , thescope type display 3 a includes adisplay 31 a, agrip section 32, anattachment section 33, a terminal 34 (seeFIG. 4 ), and an angle adjustment joint 35. The non-scope type display 3 b includes adisplay 31 b, agrip section 32, anattachment section 33, a terminal 34 (seeFIG. 4 ), and an angle adjustment joint 35 as illustrated inFIG. 12 . Theattachment section 33 of the scope andnon-scope type display 3 a or 3 b is attachable to the mountingsection 41 of thedisplay supporting arm 4 of theremote control apparatus 100. In other words, the scope ornon-scope type display 3 a or 3 b mounted on theremote control apparatus 100 is configured to be supported by thedisplay supporting arm 4. This allows theremote control apparatus 100 to be used as either an immersive remote control apparatus or an open-type remote control apparatus. Theremote control apparatus 100 is versatile in terms of thedisplay 3. - Surgery often takes several hours. Surgeons who work for a long time with an immersive remote control apparatus sometimes experience a sense of isolation. Switching the
remote control apparatus 100 to an open-type remote control apparatus before or during surgery makes surgeons more likely to have a sense of performing the surgery within a team. - The display of the remote control apparatus is versatile and expandable. If the display is broken or damaged, it is therefore only necessary to repair the display, and it is unnecessary to replace the entire apparatus. Moreover, the display can be upgraded without replacing the entire apparatus each time a higher definition or a higher quality display is developed. The operator can select a display of a favorite maker and favorite specifications (size, shape, type of operation panel, and the like).
- The terminal 34 includes a terminal capable of transmitting video, such as a serial digital interface (SDI) terminal, an analogue component terminal, a high-definition multimedia interface (HDMI, registered trademark) terminal, or a universal serial bus (USB) terminal. The terminal 34 is connected to the control apparatus 6. By connecting connection wire to the terminal 34, the
display 3 receives image information transmitted from the control apparatus 6. Thedisplay 3 is dismounted from theremote control apparatus 100 when the connection wire from the terminal 34 is disconnected. - When the
scope type display 3 a is mounted, 3D image captured by theendoscope 201 b held by the camera arm 201B of the patient-side system 200 is displayed on thescope type display 3 a. When the non-scope type display 3 b is mounted, 3D image captured by theendoscope 201 b provided to the patient-side system 200 is displayed on the non-scope type display 3 b. When the non-scope type display 3 b is mounted, 2D image captured by theendoscope 201 b provided to the patient-side system 200 may be displayed on the non-scope type display 3 b. - The
scope type display 3 a is a viewer that the operator O looks into. Thescope type display 3 a displays an image for the right eye of the operator O and an image for the left eye. Thescope type display 3 a is a stereoscope, for example. Thedisplay 31 a includes a display for the right eye and a display for the left eye. When the operator O is looking into thedisplay 31 a, the display for the right eye cannot seen by the left eye while the display for the left cannot be seen by the right eye. Thedisplay 31 a is composed of a liquid crystal display, an organic EL display, or the like. Thedisplay 31 a may be a projection-type display. - The non-scope type display 3 b is an open-type display that the operator O is able to see without looking into and is a direct-view-type display. The
display 31 b of the non-scope type display 3 b includes a flat or curved screen. Thedisplay 31 b can be a display with a diagonal of 10 to 90 inches, for example. Considering the balance between sufficient visibility of the surgical field and easy replacement, thedisplay 31 b preferably has a diagonal of 15 to 30 inches. Thedisplay 31 b is composed of a liquid crystal display, an organic EL display, or the like. Thedisplay 31 b can be a projection-type display. The non-scope type display 3 b may employ a publicly-known stereoscopy in order for the operator O to stereoscopically view an image captured by theendoscope 201 b, such as a method using polarization glasses or a method using active shutter glasses. - The
grip section 32 is gripped when thedisplay 3 is mounted, dismounted, or moved. Thegrip section 32 can be gripped with one hand. Thegrip section 32 has a grip, recessed, or protrusion shape. Thegrip section 32 is provided on a lateral side or back side of thedisplay 3 so as not to interfere with viewing thedisplay 31 a (31 b). Thegrip section 32 can be gripped with one hand, and thegrip section 32 may includeplural grip sections 32. For example, thegrip sections 32 may be provided on both sides of thedisplay 3 as illustrated inFIG. 2 , for example, so that the operator O sitting in front of thedisplay 3 can grip anygrip section 32 with either right or left hand. Eachgrip section 32 includes atrigger lever 321. Thetrigger lever 321 is an example of an unlocking mechanism. - The
attachment section 33 is attached to the mountingsection 41 of thedisplay supporting arm 4. The mountingsection 41 is detachably attached selectively to the scope ornon-scope type display 3 a or 3 b, for example. Theattachment section 33 includes anengagement section 331 as illustrated in a first example ofFIGS. 8A to 8C . The mountingsection 41 includes arelease button 411 and anengagement section 412. As illustrated inFIG. 8A , in a fixed state, theengagement section 331 of theattachment section 33 is engaged with theengagement section 412 of the mountingsection 41, so that theattachment section 33 is locked with the mountingsection 41 of thedisplay supporting arm 4. Thedisplay 3 is thereby fixed and supported by thedisplay supporting arm 4. In other words, theengagement sections non-scope type display 3 a or 3 b). - As illustrated in
FIG. 8B , when therelease button 441 is pressed down, theengagement section 412 moves and disengages from theengagement section 331. Theengagement section 33 is thereby unlocked from the mountingsection 41. Therelease button 411 functions as a disengaging mechanism that releases the engagement by the display engaging mechanism composed of theengagement sections - As illustrated in
FIG. 8C , thegrip section 32 of thedisplay 3 is operated upward in the vertical direction while the disengaging mechanism is acting downward in the vertical direction, so that thedisplay 3 is dismounted from theremote control apparatus 100. In such a manner, thedisplay 3 is dismounted by performing the releasing operation downward in the vertical direction and the operation of raising the grip section upward in the vertical direction, that produce forces in the opposite directions. Thedisplay 3 is therefore dismounted stably and safely. Thedisplay 3 can be dismounted upward with space away from thedisplay supporting arm 4, not interfering with the operation handles 1 located underneath. - The display engaging mechanism and disengaging mechanism may have another configuration and may be configured as illustrated in
FIGS. 9A to 9C as a second example. Theattachment section 33 includes anengagement section 332 as shown inFIGS. 9A to 9C . The mountingsection 41 includes anengagement section 413. As illustrated inFIG. 9A , in the fixed state, theengagement section 332 of theattachment section 33 is engaged with theengagement section 413 of the mountingsection 41, so that theattachment section 33 is locked with the mountingsection 41 of thedisplay supporting arm 4. Specifically, theengagement section 332 sandwiches and grips theengagement section 413. Thedisplay 3 is thereby fixed to and supported by thedisplay supporting arm 4. In other words, theengagement sections non-scope type display 3 a or 3 b). - As illustrated in
FIG. 9B , when theengagement section 332 is pressed on both sides, the grip by theengagement section 332 is released, so that theengagement section 332 disengages from theengagement section 413. Theattachment section 33 is thereby unfixed (unlocked) from the mountingsection 41. As illustrated inFIG. 9C , thegrip sections 32 is operated upward in the vertical direction while theattachment section 33 is unlocked. Thedisplay 3 is thereby dismounted from theremote operation apparatus 100. - The display engaging mechanism and release mechanism may have still another configuration as illustrated in
FIGS. 10A to 10C as a third example. Theattachment section 33 includes anotch 333 as shown inFIGS. 10A to 10C . The mountingsection 41 includes arelease button 414, afitting section 415, and anengagement section 416. As illustrated inFIG. 10A , therelease button 414 is energized upward in the vertical direction by a spring or the like. Theengagement section 416 is energized in a horizontal direction away from thefitting section 415. The vertical movement of therelease button 414 and the horizontal movement of theengagement section 416 work in conjunction with a gear and the like. - In the fixed state, the
notch 333 of theattachment section 33 is engaged with theengagement section 416 of the mountingsection 41, so that theattachment section 33 is locked with the mountingsection 41 of thedisplay supporting arm 4. Thedisplay 3 is thereby fixed to and supported by thedisplay supporting arm 4. In other words, thenotch 333 andengagement section 416 constitute the display engaging mechanism to fix the display 3 (the scope ornon-scope type display 3 a or 3 b). - As illustrated in
FIG. 10B , when therelease button 414 is pressed down, thefitting section 415 moves downward. Theengagement section 416 then moves toward thefitting section 415 and fits into thefitting section 415. Thenotch 333 thereby disengages from theengagement section 416. Theattachment section 33 is then unlocked from the mountingsection 41. In other words, therelease button 414 functions as the disengaging mechanism to release the engagement by the display engaging mechanism composed of thenotch 333 andengagement section 416. The disengaging mechanism releases the engagement by the display engaging mechanism by an action of vertically downward force. - As illustrated in
FIG. 10C , thegrip section 32 of thedisplay 3 is operated upward in the vertical direction while theattachment section 33 is unlocked. Thedisplay 3 is thereby dismounted from theremote operation apparatus 100. - Having a lower-side length larger than an upper-side length, the
engagement section 416 has a slope. When theattachment section 33 is pressed vertically downward against the mountingsection 41, theattachment section 33 comes into contact with the slope of theengagement section 416 and presses theengagement section 416 into thefitting section 415 in the horizontal direction. When theattachment section 33 moves to a predetermined position, theengagement section 416 fits into thenotch 333 and is locked in the fixed state. - The
display supporting arm 4 supports thedisplay 3 as illustrated inFIG. 2 . Thedisplay supporting arm 4 includes the mountingsection 41, anarm section 42,plural joints 43, and aparallel link mechanism 44. At an end of thedisplay supporting arm 4, the mountingsection 41 is provided. The other end thereof is supported by acolumn 45. Thecolumn 45 is fixed to a supportingsection 91 of the supportingmechanism 9. Thedisplay 3 is thus supported by the supportingsection 91. Thedisplay supporting arm 4 is rotatable around rotation axes A1, A2, and A3, which extend vertically. Thedisplay supporting arm 4 is configured so that the mountingsection 41 is moved up and down by theparallel link mechanism 44. The mountingsection 41 is thus supported with four degrees of freedom by thearm section 42. - The
display supporting arm 4 includesjoints joints 43. Thejoints 43 a to 43 c are respectively provided withelectromagnetic brakes electromagnetic brakes 431. Theparallel link mechanism 44 includes anelectromagnetic brake 441 a as anelectromagnetic brake 441. Thejoints 43 a to 43 c andparallel link mechanism 44 are examples of a joint, and theelectromagnetic brakes 431 a to 431 c and 441 a are examples of a locking mechanism. - As illustrated in
FIG. 2 , thescope type display 3 a is attached to thedisplay supporting arm 4. In other words, thedisplay supporting arm 4 supports thescope type display 3 a. - The joint 43 a connects the mounting
section 41 and athird link 48 so that the mountingsection 41 andthird link 48 rotate around the rotation axis A3. The joint 43 b connects asecond link 47 and afirst link 46 so that the second andfirst links first link 46 andcolumn 45 so that thefirst link 46 andcolumn 45 rotate around the rotation axis A1. As illustrated inFIG. 3 , theparallel link mechanism 44 connects the third andsecond links - The
electromagnetic brakes 431 are configured to lock thejoints 43. Specifically, while not energized, eachelectromagnetic brake 431 presses at least one of two links connected at the corresponding rotation axis to prevent motion of the joint 43 into the locked state. While energized, magnetic force generated by the electromagnetic coil separates theelectromagnetic brake 431 from the pressed link, thus unlocking the joint 43. Theelectromagnetic brake 431 a presses the mountingsection 41 at the rotation axis A3 to lock the joint 43 a. Theelectromagnetic brake 431 b presses thesecond link 47 at the rotation axis A2 to lock the joint 43 b. Theelectromagnetic brake 431 c presses thefirst link 46 at the rotation axis A1 to lock the joint 43 c. - The
electromagnetic brake 441 a is configured to lock theparallel link mechanism 44. Specifically, while not energized, theelectromagnetic brake 441 a presses theparallel link mechanism 44 to lock the same. While energized, theelectromagnetic brake 441 a unlocks theparallel link mechanism 44. - The
grip section 32 of thedisplay 3 is provided with thetrigger lever 321 as the unlocking mechanism to release the lock of theelectromagnetic brakes trigger lever 321 is pressed down, the correspondingelectromagnetic brake trigger lever 321 is operated by the operator O to unlock the corresponding joint (at least one of thejoints 43 a to 43 c and parallel link mechanism 44). - The
trigger lever 321 includes twotrigger levers 321 disposed on the right and left sides of thedisplay 3 by way of example. As illustrated inFIG. 2 , trigger levers 321 a are individually provided on the right and left side of thescope type display 3 a. As illustrated inFIG. 12 , trigger levers 321 b are individually provided on the right and left sides of the non-scope type display 3 b. Eachtrigger lever 321 is gripped with the grip section 32 (pressing operation) for the unlocking operation. When both of the right and left trigger levers 321 are pressed, all the joints (thejoints 43 a to 43 c and parallel link mechanism 44) are unlocked. When either the right orleft lever 321 is not pressed or any of the right and leftlevers 321 is not pressed, any joint is not unlocked. In such a configuration, the joints cannot be unlocked even if one of the trigger levers 321 is touched and is pressed accidentally. Thejoints 43 andparallel link mechanism 44 are prevented from being unlocked accidentally. - While any of the right and left trigger levers 321 is not pressed, all the joints of the
display supporting arm 4 are locked. This prevents the position of thedisplay 3 from shifting during operation of the operation handles 1. When the operation for the operation handles 1 is stopped and both of the right and left trigger levers 321 are pressed, all the joints of thedisplay supporting arm 4 are unlocked, so that the operator O can arbitrarily change the position of thedisplay 3. The operator O is able to change thedisplay 3 to any position easily. Since thedisplay 3 is supported by thedisplay supporting arm 4 composed of plural joints and links as described above, thedisplay 3 is adjustable in a wide range and can move to any place in a linear manner, compared with a mechanism just capable of adjusting the angle and the positions in the height and depth directions, of a display as described in Patent Literature 1. When thedisplay 3 is thescope type display 3 a, that the operator O looks into, the operator O can press the both right and left trigger levers 32 a and move thescope type display 3 a to a desired position while looking into thescope type display 3 a. Theremote control apparatus 100 therefore allows the operator O to change his/her posture sensuously and quickly compared with the case where the operator checks the posture with his/her face affixed on thedisplay 3 each time the operator separately sets the angle, height, and depth of thedisplay 3. - As described above, with this
remote control apparatus 100, the operator can easily change the posture in a wide range of adjustment during long surgery. It is therefore possible to reduce the operator's feeling of fatigue and ill effects on the operator's health of remaining in the same posture. - The
display supporting arm 4 is placed on the opposite side of thedisplay 3 from the operator O. Thedisplay supporting arm 4 is placed in the back side (on the Y2 side) of thedisplay 3. This prevents thedisplay supporting arm 4 and the operator O from interfering with each other, effectively increasing the freedom of movement of thedisplay supporting arm 4. - The
parallel link mechanism 44 includes theelectromagnetic brake 441,links spring 444, and abase section 445 as illustrated inFIG. 3 . Theparallel link mechanism 44 is configured to translate thedisplay 3 attached to the mountingsection 41 up and down. In other words, theparallel link mechanism 44 is configured to move thedisplay 3 up and down without changing the angle of the display screen of thedisplay 3. - To be specific, in the
parallel link mechanism 44, thelink 442 a is rotatably connected to thepivots link 442 b is rotatably connected to thepivots links pivots pivots pivots 443 a to 443 d are thus located on vertices of a parallelogram. In other words, the line connecting thepivots pivots pivots section 41 moves up and down, the angle of the mountingsection 41 to the vertical direction is kept constant. The horizontal position of the mountingsection 41 is slightly shifted when the mountingsection 41 is moved up or down by theparallel link mechanism 44. - The
electromagnetic brake 441 is attached to thepivot 443 a. Theelectromagnetic brake 441 presses thesecond link 47 andparallel link mechanism 44 to lock the rotation of thepivot 443 a. When the rotation of thepivot 443 a is locked, the rotation of thepivots 443 b to 443 d, which are connected thereto by thelinks - The
spring 444 is provided to press thebase section 445 of thesecond link 47. Thebase section 445 has a protruding bow-like shape. When the end of thespring 444 on thesecond link 47 side presses the bow-like base section 445, the end of thespring 444 tries to move upward along the bow-like base section 445, generating a force to rotate upward the end of theparallel link mechanism 44 opposite to thesecond link 47. Even if thedisplay 3 needs to move against the gravity, therefore, the operator O is able to move upward easily. - The angle adjustment joint 35 is provided between the
display supporting arm 4 anddisplay 3 separately from thejoints 43 andparallel link mechanism 44 of thedisplay supporting arm 4. The angle adjustment joint 35 adjusts the angle of the display screen of thedisplay 3. The angle adjustment joint 35 includes an angle adjustment joint 35 a and an angle adjustment joint 35 b. The angle adjustment joint 35 a supports thescope type display 3 a so that thescope type display 3 a is rotatable in a direction C1 (seeFIG. 2 ). The angle adjustment joint 35 b supports the non-scope type display 3 b so that the non-scope type display 3 b is rotatable in a direction C2 (seeFIG. 12 ). The angle adjustment joint 35 is provided on thedisplay 3 side when thedisplay 3 is dismounted from thedisplay supporting arm 4. The angle of the display screen of thedisplay 3 can be thereby changed independently. This facilitates adjustment of the angle of the display screen of thedisplay 3. - The positioning of the
display supporting arm 4 may be changed manually by the operator O or others or may be changed under movement control by a driver including a motor, a position detector, such as an encoder, and a brake. Thedisplay supporting arm 4 can be manually moved or electrically moved. When thedisplay 3 is manually moved with the brake released, the motor also operates following the motion of thedisplay 3 manually operated, and the position of thedisplay 3 can be stored by the position detector. In the case of electrically moving thedisplay 3, motions may be instructed with a handheld or the like. The handheld may be provided with a release button to release the brake. Alternatively, the brake may be released automatically by operating a movement direction instruction button. The handheld may be composed of a remote controller including plural buttons or a teaching pendant, for example. In addition, the position of the display 3 (the positioning of the display supporting arm 4) may be stored for each surgeon. The position of the display 3 (the positioning of the display supporting arm 4) may be changed in cooperation with transition between the standing position and sitting position. - The
armrest 5 supports arms of the operator O. Thearmrest 5 includes anarm supporting section 51 and a pair of connectingsections 52, and anoperating section 53. Thearm supporting section 51 is located in front (on the Y1 side) of the operation handles 1 and is configured to support the arms of the operator O. This stabilizes the arms of the operator O, so that the operator O can stably operate the operation handles 1. Even when the end effectors need to be moved finely, the operator O performs stabilized operation with elbows and the like on thearm rest 5. The operator O feels less strain even in long surgery. Thearm supporting section 51 extends in the X direction. The pair of connectingsections 52 are provided to both ends of thearm supporting section 51 so as to sandwich thearm supporting section 51 in the X direction. The connectingsections 52 support thearm supporting section 51. The connectingsections 52 extend in the Y direction. The end of each connectingsection 52 on the Y1 side is connected to thearm supporting section 51. The ends of the connectingsections 52 on the Y2 side are connected to the supportingsection 91 of the supportingmechanism 9. Thearmrest 5 is thus supported by the supportingmechanism 9. As illustrated inFIG. 2 , the connectingsections 52 may be extended downward from the back side (the Y2 side) to the front side (the Y1 side). As illustrated inFIGS. 5 and 6 , the connectingsections 52 may be extended upward from the back side (the Y2 side) to the front side (the Y1 side). Alternatively, the connectingsections 52 may be extended in the horizontal direction. The operatingsection 53 enables operation for settings of theremote control apparatus 100. For example, the operatingsection 53 enables operation for positioning theremote control apparatus 100. In this case, the operatingsection 53 functions as thepositioning section 8 a. The operatingsection 53 may function as theoperating section 8 b. The operatingsection 53 includes a touch panel, for example. - As illustrated in
FIG. 4 , the control apparatus 6 includes acontroller 61, astorage 62, and animage controller 63, for example. Thecontroller 61 includes a calculator such as a CPU. Thestorage 62 includes a memory, such as a ROM and a RAM. The control apparatus 6 may be composed of a single controller performing centralized control or may be composed of plural controllers that perform decentralized control in cooperation with each other. Thecontroller 61 determines whether the action mode instruction inputted by the operation handles 1 is to be executed by theinstruments 201 a or to be executed by theendoscope 201 b, depending on the state of theoperation pedal section 2. When determining that the action mode instruction inputted by the operation handles 1 is to be executed by theinstruments 201 a, thecontroller 61 transmits the action mode instruction to theinstrument arm 201A. Theinstrument arms 201A are thereby driven for control of motions of theinstruments 201 a attached to theinstrument arms 201A. - When determining that the action mode instruction inputted by the operation handles 1 is to be executed by the
endoscope 201 b, thecontroller 61 transmits the action mode instruction to the camera arm 201B. The camera arm 201B is thereby driven for control of motions of theendoscope 201 b attached to the camera arm 201B. - The
storage 62 stores control programs corresponding to the types of theinstruments 201 a, for example. Thecontroller 61 reads the stored control programs according to the types of the attachedinstruments 201 a. The action mode instructions from the operation handles 1 and/or theoperation pedal section 2 of theremote control apparatus 100 thereby causes therespective instruments 201 a to perform proper motions. - The
image controller 63 transmits an image acquired by theendoscope 201 b to theterminal 34 of thedisplay 3. Theimage controller 63 modifies the image if necessary. - The
positioning section 8 a receives operations to move up and down the operation handles 1, thedisplay 3 supported by thedisplay supporting arm 4, and thearm rest 5. Thepositioning section 8 a also receives operations to transform theremote control apparatus 100 between a first configuration and a second configuration. - The
positioning section 8 a is an operating section that receives a configuration change instruction to change the configuration of theremote control apparatus 100 to the standing position (the first configuration) or the sitting position (the second configuration). Thepositioning section 8 a includes plural operation buttons. - The supporting
mechanism 9 includes the supportingsection 91 and thedriver 92. The supportingsection 91 supports the operation handles 1 andarmrest 5. The supportingsection 91 supports thedisplay 3 through thedisplay supporting arm 4. Thedriver 92 is configured to move the supportingsection 91 up and down. To be specific, thedriver 92 includes a motor and an encoder, for example, and moves the supportingsection 91 up and down under control by thecontrol apparatus 61. The supportingmechanism 9 may allow the operator O or others to manually change the positioning. In addition, thedriver 92 of the supportingmechanism 9 may be driven pneumatically or hydraulically. Thearmrest 5 may be rotated relative to the supportingmechanism 9 for adjustment of the position. For example, thearmrest 5 may be rotated around the rotation axis along the X direction. - The supporting
mechanism 9 is configured to transition between a first mode and a second mode. In the first mode (seeFIG. 5 ), the operation handles 1 which are positioned at a neutral position A0 of the operation range A are placed and held at a height position H1, which is 85 cm or more above the floor surface on which theremote control apparatus 100 is installed, for example. In the second mode (seeFIG. 6 ), the operation handles 1 which are positioned at the neutral position A0 of the operation range A are placed and held at a height position H2, which is 48 cm or more below the height position H1. When the operation handles 1 which are positioned at the neutral position A0 of the operation range A, are located at the height position H1 (85 cm or more above the floor surface), the operator O is able to operate the operation handles 1 while standing up. When the operation handles 1 which are positioned at the neutral position A0 of the operation range A are located at the height position H2 (48 cm or more below the height position H1), the operator O is able to operate the operation handles 1 while sitting down. The operator O is thus able to operate theremote control apparatus 100 in a desired posture. In addition, since the operation handles 1 are supported by the supportingmechanism 9, the operator O does not need to support the operation handles 1. This prevents an increase in strain on the operator O. Thearmrest 5 supporting the arms of the operator O further reduces the strain on the operator O and stabilizes the arms of the operator O. The operator O is therefore able to stably operate the operation handles 1. - The supporting
mechanism 9 is configured to transition between the first mode (seeFIG. 5 ), in which the operation handles 1 are held so that the operation range A of the operation handles 1 is within a clean area set at a predetermined height position or more above the floor surface on which theremote control apparatus 100 is installed, and the second mode (seeFIG. 6 ), in which the operation handles 1 are held so that at least a part of the operation range A of the operation handles 1 is located below the clean area. - In operation rooms, clean technique is used in order to prevent surgical incision sites and medical equipment from being contaminated by pathogen, foreign matters, or the like. In the clean technique, a clean area and a contaminated area, which is other than the clean area, are defined. The area from the floor surface to a certain height position H where foreign matters including dust and grit are more likely to remain is treated as the contaminated area in principle and is eliminated from the clean area. This area lies from the floor surface to a height position of about 70 cm, for example. The clean area is therefore set to a height position of 70 cm or more above the floor surface on which the
remote control apparatus 100 is installed, for example. Members of the surgical team including the operator O make sure that only sterile objects are placed in the clean area during surgery and perform sterilization for an object which is to be moved from the contaminated area to the clean area. Similarly, when the members of the surgical team including the operator O locate their hands in the contaminated area, the members sterilize their hands before directly touching objects located in the clean area. The operation handles 1 are treated as unclean objects. Even if the operation handles 1 are located in the clean area, the operator O never accesses the patient P without sterilization or use of drape while operating the operation handles 1. - When the operation handles 1 are located so that the operation range A of the operation handles 1 is within the clean area set at the predetermined height or more above the floor surface, the operator O is able to operate the operation handles 1 while keeping his/her hands inside the clean area. If the operation handles 1 are cleaned, for example, the hands of the operator O is kept clean. When the operation handles 1 are held so that at least a part of the operation range A of the operation handles 1 is located below the clean area, the sitting operator O is able to operate the operation handles 1 at the low position. The operator O is thus able to operate the
remote control apparatus 100 in a desired posture. In addition, the operation handles 1 are supported by the supportingmechanism 9, and the operator O does not need to support the operation handles 1. This can prevent an increase in strain on the operator O. - The supporting
mechanism 9 is also configured to allow for transition between the first mode (seeFIG. 5 ), in which the operation handles 1 are held at the position suitable for the operator O to operate the operation handles 1 while standing up and the second mode (seeFIG. 6 ) in which the operation handles 1 are held at the position suitable for the operator O to operate the operation handles 1 while sitting down. When theremote operation apparatus 100 is set to the first mode, the operator O can operate the operation handles 1 while standing up. When theremote operation apparatus 100 is set to the second mode, the operator O is able to operate the operation handles 1 while sitting down. The operator O is thus able to operate theremote control apparatus 100 in a desired posture. In addition, the operation handles 1 are supported by the supportingmechanism 9, and the operator O does not need to support the operation handles 1. This can reduce an increase in strain on the operator O. - The supporting
mechanism 9 is configured to move both the operation handles 1 andarmrest 5 up and down at transition between the first and second modes. Specifically, the supportingmechanism 9 is configured to integrally move the operation handles 1 andarmrest 5 up and down at transition between the first and second modes. This requires less components than that in the case where members for moving the operation handles 1 andarmrest 5 up and down are separately provided. It is therefore possible to simplify the apparatus configuration and prevent an increase in size of the apparatus. In addition, the supportingmechanism 9 is configured to move thedisplay 3 supported by thedisplay supporting arm 4 up and down at transmission between the first and second modes. The supportingmechanism 9 thus integrally moves the operation handles 1,armrest 5, anddisplay 3 up and down at transition between the first and second modes. - The supporting
mechanism 9 supports thedisplay 3 that displays an image captured by theendoscope 201 b and supports thedisplay 3 so that the position of thedisplay 3 relative to the operation handles 1 is changeable in each of the first and second modes. To be specific, the position of thedisplay 3 is moved relative to the operation handles 1 by thedisplay supporting arm 4 supported by the supportingmechanism 9. The position of thedisplay 3 relative to the operation handles 1 can be therefore changed according to the physique and posture of the operator O. This can increase the versatility of thedisplay 3. - Operation for the patient-side system 200 by the operation handles 1 is disabled at transformation between the first and second modes. To be specific, during transformation between the first and second modes, operation by the operation handles 1 is disabled, or transmission of action mode instructions is disabled. In other words, during transformation between the first and second modes, the
control apparatus 61 does not transmit an action mode instruction to the patient-side system 200 even if the action mode instruction is transmitted from the operation handles 1. This prevents the patient-side system 200 from working when the operation handles 1 are operated accidentally during transformation between the first and second modes. - As illustrated in
FIG. 5 , when theremote control apparatus 100 is in the standing position (the first configuration), the operation handles 1 are positioned at a height suitable for the standing operator O to grip the operation handles 1 positioned at the neutral position A0 with the arms bent at substantially right angles. Thedisplay 3 is positioned at a height suitable for the standing operator O to look at thedisplay 3. When thescope type display 3 a is mounted, for example, thescope type display 3 a is set at the same height as the eyes of the operator O. - When the area from the floor surface to a height position H of 70 cm is set to the contaminated area in a surgery room, the operation range A of the operation handles 1 is fully within the clean area 70 cm or more above the floor surface in the standing position mode (the first configuration) by designing based on a human model for ergonomics.
- When the
remote control apparatus 100 is in the standing position (the first configuration), theoperation pedal section 2 is moved to a position P1 in the front side (in the Y1 side) of theremote control apparatus 100. In other words, theoperation pedal section 2 is located to such a position that the standing operator O reaches theoperation pedal section 2 with his/her foot while touching the operation handles 1 with his/her hands. - As illustrated in
FIG. 6 , when theremote control apparatus 100 is in the sitting position (the second configuration). The operation handles 1 are positioned at a height suitable for the operator O sitting in the chair to grip the operation handles 1 positioned at the neutral position A0 with his/her arms bent at substantially right angles. In addition, thedisplay 3 is positioned at a height position suitable for the operator O sitting in the chair to look at thedisplay 3. When thescope type display 3 a is mounted, for example, thescope type display 3 a is set at the same height as the eyes of the operator O. With theremote control apparatus 100, the operator O can execute surgery while sitting down in a long surgery. This can reduce fatigue of the operator O. - When the area from the floor surface to the height position H of 70 cm is set to the contaminated area in a surgery room, at least a part of the operation range A of the operation handles 1 is in the contaminated area in the sitting position mode (the second configuration) by designing based on human models for ergonomics.
- When the
remote control apparatus 100 is in the sitting position (the second configuration), theoperation pedal section 2 is located to a position P2 in the back side (in the Y2 e side) of theremote control apparatus 100. In other words, theoperation pedal section 2 is located to such a position that the sitting operator O reaches theoperation pedal section 2 with his/her feet while touching the operation handles 1 with his/her hands. Theoperation pedal section 2 is movable forward and backward by 300 mm or more (in the Y direction), for example. Preferably, theoperation pedal section 2 is movable forward and backward by 350 mm or more (in the Y direction). Theoperation pedal section 2 can be therefore easily located to the positions suitable for the first and second configurations. - Specific dimensions and the like of the
remote control apparatus 100 are designed using measurement data described in “1988 ANTHROPOMETRIC SURVEY OF U.S. ARMY PERSONNEL: METHODS AND SUMMARY STATISTICS (1988)”. - The
remote control apparatus 100 may be designed with reference to JIS standards. For example, “JIS Z8503-4: 2006 (ISO 11064-4: 2004), Ergonomic design of control centres, Part 4: Layout and dimensions of workstations” prescribes use of the 5th and 95th percentile human models. - The operation range A is defined as a region between 15 cm above and below the neutral position A0. The dimension of the operation range A in the height direction is defined as 30 cm. The operation range A is defined based on the dimensions of the motion range of surgical tools set to keep good operability of the surgical tools at laparoscopic surgery and the motion scaling ratio of the operation handles 1. The set motion range of the surgical tools has a dimension of 30 cm in the height direction, and the motion scaling ratio of the operation handles 1 is ½. The dimension of the operation range A in the height direction is therefore 30 cm based on the dimension of the motion range of the surgical tools in the height direction and the motion scaling ratio of the operation handles 1.
-
FIGS. 7A and 7B are views illustrating models of operators O,FIG. 7A illustrating a model of large operators O1, andFIG. 7B illustrating a model of small operators O2. - In
FIG. 7A , the model of the large operators O1 is based on body data of German men. When the fifth largest model among 100 German male models selected at random stands and grips the operation handles 1 positioned at the neutral position A0 of the operation range A with his arms bent at right angles, the height position of the operation handles 1 is about 1176 mm, and the lower and upper limits of the height position of the operation range A are about 1026 mm and 1326 mm, respectively. On the other hand, when the fifth largest model sits down and grips the operation handles 1 positioned at the neutral position A0 of the operation range A with his arms bent at right angles, the height position of the operation handles 1 is about 703 mm, and the lower and upper limits of the height position of the operation range A are about 553 mm and about 853 mm, respectively. - In
FIG. 7B , the model of the small operators O2 is based on body data of Japanese women. When the fifth smallest model among 100 Japanese female models selected at random stands and grips the operation handles 1 positioned at the neutral position A0 of the operation range A with her arms bent at right angles, the height position of the operation handles 1 is about 992 mm, and the lower and upper limits of the height position of the operation range A are about 842 mm and about 1142 mm, respectively. On the other hand, when the fifth smallest model sits down and grips the operation handles 1 positioned at the neutral position A0 of the operation range A with her arms bent at right angles, the height position of the operation handles 1 is about 643 mm, and the lower and upper limits of the height position of the operation range A are about 493 mm and about 793 mm, respectively. - Based on the aforementioned data, the height position of the operation handles 1 that allows plural operators O having different types of physique to take standing and sitting positions without any problem is as follows. First, the height position of the operation handles 1 positioned at the neutral position A0 of the operation range A in the standing position mode (the first mode) is preferably set to about 99 cm or more corresponding to the standing model of the small operators O2. This allows most operators O to comfortably operate the operation handles 1 while standing. When the operation handles 1 are configured to move down by 15 cm from the neutral position A0, the lower limit of the height position of the operation range A of the operation handles 1 in the standing position mode is 84 cm or more as described above.
- The height position of the operation handles 1 positioned at the neutral position A0 in the standing position mode (the first mode) is preferably set to about 85 cm or more. When the operation handles 1 are configured to move down by 15 cm from the neutral position A0, the lower limit of the height position of the operation range A of the operation handles 1 in the standing position mode is higher than 70 cm, and the operation range A of the operation handles 1 is therefore within the clean area. Since the lower limit of the height position of the operation range A corresponding to the standing model of the small operators O2 is about 84 cm, setting the lower limit of the height position of the operation range A to 70 cm allows more operators O having different types of physiques to comfortably operate the operation handles 1 while standing up.
- Next, the height position of the operation handles 1 positioned at the neutral position A0 of the operation range A in the sitting position mode (the second mode) is preferably set to about 64 cm or more corresponding to the sitting model of the small operators O2. This allows most operators O to comfortably operate the operation handles 1 while sitting down.
- Next, the displacement (adjustment width) of the height position of the operation handles 1 at transition of the
remote control apparatus 100 between the standing position mode and the sitting position mode is preferably set to about 35 cm or more. This is the difference between the height (about 99 cm) of the operation handles 1 positioned at the neutral position A0 corresponding to the standing model of the small operators O2 and the height (about 64 cm) of the operation handles 1 positioned at the neutral position A0 corresponding to the sitting model of the small operators O2. - In addition, the displacement of the height position of the operation handles 1 at transition of the
remote control apparatus 100 between the standing position mode and the sitting position mode is preferably set to about 48 cm or more. This is the difference between the height (about 118 cm, the maximum height of the operation handles 1 positioned at the neutral position A0 in the standing position mode in this example) of the operation handles 1 positioned at the neutral position A0 corresponding to the standing model of the large operators O1 and the height (about 70 cm) of the operation handles 1 positioned at the neutral position A0 corresponding to the sitting model of the large operators O1. - As described above, the adjustment width of the height position of the operation handles 1 at transition between the standing position mode and the sitting position mode is greater than the adjustment width desirably set so as to fit to the different types of physique of the operators O in the standing position mode (about 19 cm as the difference between the height position of the operation handles 1 positioned at the neutral position A0, corresponding to the model of the large operators O1 and the height position of the operation handles 1 positioned at the neutral position A0, corresponding to the model of the small operators O2, for example) and the adjustment width desirably set so as to fit to the different types of physique of the operators O in the sitting position mode (about 6 cm as the difference between the height position of the operation handles 1 positioned at the neutral position A0 corresponding to the model of the large operators O1 and the height position of the operation handles 1 positioned at the neutral position A0 corresponding to the model of the small operators O2, for example).
- If the positions of the operation handles 1 are set higher than about 118 cm (the height position of the operation handles 1 positioned at the neutral position A0 corresponding to the standing model of the large operators O1), the above-described adjustment width is further increased. It is then preferable that the adjustment width is 50 cm or more from the height position of the operation handles 1 in the standing position mode. Furthermore, the displacement of the height position of the operation handles 1 at transition of the
remote control apparatus 100 between the standing position mode and the sitting position mode is preferably set to about 54 cm or more, which is the difference between the height (about 118 cm) of the operation handles 1 positioned at the neutral position A0 corresponding to the standing model of the large operators O1 and the height (about 64 cm) of the operation handles 1 positioned at the neutral position A0 corresponding to the sitting model of the small operators O2. As for definition of the operation range A, the design of the operation range A may be modified by considering the size of the operation handles 1 and the like. Although the vertical width of the operation range A is assumed to be 30 cm, the vertical width thereof may be set to 20, 25, or 35 cm, for example. - Next, a second embodiment is described with reference to
FIG. 12 . In the second embodiment, description is given of an example of the configuration of a remote control apparatus including plural display supporting arms, which is different from the first embodiment in which the remote control apparatus includes one display supporting arm. - As illustrated in
FIG. 12 , aremote control apparatus 400 according to a second embodiment includes pluraldisplay supporting arms 4. In theremote control apparatus 400, thedisplay supporting arms 4 includedisplay supporting arms FIG. 12 , thescope type display 3 a and non-scope type display 3 b as thedisplays 3 are attached to thedisplay supporting arms remote control apparatus 400, respectively. The twodisplays 3 are placed right and left (side by side in the X direction). Thedisplay supporting arms - In other words, the
remote control apparatus 400 includes plural (two) mountingsections 41. Specifically, theremote control apparatus 400 includes the two display supporting arms 4 (4 a, 4 b). The mountingsections 41 are provided to the respective tips of thedisplay supporting arms remote control apparatus 400. This effectively increases the versatility of thedisplays 3. - In a second embodiment, the non-scope type display 3 b, which is one of the
displays 3, displays at least one of a previously acquired image of the surgical site, information indicating the state of the surgery, and operation information. The non-scope type display 3 b displays X-ray images or magnetic resonance images previously captured. The other scope type or non-scope type displays a 3D or 2D image acquired from theendoscope 201 b. This further increases the versatility and expandability such that, for example, the operator O performs surgery by mainly looking at the endoscopic image on the other display, while viewing, as needed, at least one kind of auxiliary information among the image of the surgery site previously acquired, the information indicating the state of the surgery, and the operation information. - The
remote control apparatus 400 according to a second embodiment is configured so that the scope ornon-scope type display 3 a or 3 b is selectively mounted as themain display 3. In addition, the non-scope type display 3 b is mounted on theremote control apparatus 400 as an auxiliary display. The operator O can therefore select one of the immersive remote control apparatus and the open-type remote control apparatus and look at the auxiliary information during surgery. Since theremote control apparatus 400 is provided with plural mounting sections, it is possible to freely select on which side the main display is installed. - The
display supporting arm 4 a includesjoints joints 43. Thedisplay supporting arm 4 a includes aparallel link mechanism 44 a as theparallel link mechanism 44. Thejoints 43 a to 43 c are respectively provided withelectromagnetic brakes electromagnetic brakes 431. Theparallel link mechanism 44 a is provided with anelectromagnetic brake 441 a as theelectromagnetic brake 441. Thejoints 43 a to 43 c andparallel link mechanism 44 a are examples of a joint and a first joint, respectively, and theelectromagnetic brakes 431 a to 431 c and 441 a are examples of a locking mechanism and a first locking mechanism, respectively. - The
display supporting arm 4 b includesjoints joints 43. Thedisplay supporting arm 4 b includes aparallel link mechanism 44 b as theparallel link mechanism 44. Thejoints 43 d to 43 f are respectively provided withelectromagnetic brakes electromagnetic brakes 431 as illustrated inFIG. 3 . Theparallel link mechanism 44 b is provided with an electromagnetic brake 441 b as theelectromagnetic brakes 441. Thejoints 43 d to 43 f andparallel link mechanism 44 b are examples of a joint and a second joint, respectively, and theelectromagnetic brakes 431 d to 431 f and 441 b are examples of a locking mechanism and a second locking mechanism, respectively. - The trigger levers 321 a are provided on the right and left sides of the
scope type display 3 a. The trigger levers 321 b are provided on the right and left sides of the non-scope type display 3 b. The trigger levers 321 are gripped together withrespective grip sections 32 for unlocking operation. Specifically, the trigger levers 321 a are configured to unlock theelectromagnetic brakes 431 a to 431 c and 441 a of thedisplay supporting arm 4 a. The trigger levers 321 b are configured to unlock theelectromagnetic brakes 431 d to 431 f of thedisplay supporting arm 4 b. Thejoints 43 a to 43 c and theparallel link mechanism 44 a of thedisplay supporting arm 4 a and thejoints 43 d to 43 f and theparallel link mechanism 44 b of thedisplay supporting arm 4 b can be therefore unlocked independently of each other. The trigger levers 321 a and 321 b are examples of a first unlocking mechanism and a second unlocking mechanism. - In the example of
FIG. 12 , thescope type display 3 a and non-scope type display 3 b are attached to the two mountingsections 41. However, thescope type display 3 a may be attached to each of the two mountingsections 41, or the non-scope type display 3 b may be attached to each of the two mountingsections 41. - The other configurations of a second embodiment are the same as those of a first embodiment.
- (Modification of Unlocking Mechanism)
- In the examples illustrated in the above embodiments, the joints (the
joints 43 a to 43 c and the parallel link mechanism 44) are unlocked by pressing both of the twotrigger levers 321 on the right and left sides of thedisplay 3. However, the way of unlocking the locking mechanisms of the joints is not limited to these examples. - For example, the unlocking mechanism may be configured so that all the joints are unlocked with only one of the two
trigger levers 321 on the right and left sides of thedisplay 3. In this case, the operator O is able to move thedisplay 3 with one hand. The operator O therefore moves thedisplay 3 more easily. The operator O is able to change the position of thedisplay 3 with one hand regardless of whether the operator O is right-handed or left-handed. - Alternatively, the
display 3 may be provided with only onetrigger lever 321. Such a configuration includes fewer physical mechanisms around thedisplay 3, reducing interferences with other portions. In this case, a display for left-handed operators or a display for right-handed operators may be provided as needed for use. When theremote control apparatus 100 includes a mounting section to which thedisplay 3 is detachably attached, it is possible to select and use one from a display for right-handed operators and a display for left-handed operators as needed. - Moreover, the
display 3 may be provided with three or more trigger levers 321. For example, two of the trigger levers 321 are provided on the right and left sides of thedisplay 3 while onetrigger lever 321 is provided as one of the foot pedals, and thedisplay 3 is configured to move only when the threetrigger levers 321 are pressed. In this case, the position of thedisplay 3 cannot be changed until the operator O absolutely intends to move the position of thedisplay 3. - When the
display 3 is provided with plural trigger levers 321, eachtrigger lever 321 may be configured to unlock different joints. When the twotrigger levers 321 are provided on the right and left of thedisplay 3, for example, one of the right and left trigger levers 321 may be configured to unlock at least one (only the joint 43 a, for example) of the joints contributing to horizontal movement of thedisplay 3 while theother trigger lever 321 is configured to unlock at least one (theparallel link mechanism 44 in the example ofFIG. 3 ) of the joints contributing to vertical movement of thedisplay 3. In such a configuration, in addition to the aforementioned advantages of provision of plural trigger levers, movement of thedisplay 3 may be limited so that thedisplay 3 mainly moves in a desired direction. Such a configuration moreover allows only necessary joints to be movable, reducing burden on thedisplay supporting arm 4 in the process of moving thedisplay 3. - When each joint of the
display supporting arm 4 includes a motor and a position detector (an encoder, for example), the range of movement of thedisplay 3 can be limited. For example, thedisplay 3 is translated along a certain plane. When thedisplay 3 is supported by thedisplay supporting arm 4 with the display screen parallel to a plane PL tilted by 10 degrees to the XZ plane around the X axis in the XYZ coordinates as illustrated inFIG. 11 , for example, thecontrol apparatus 61 may perform a control so as to translate thedisplay 3 along only the plane PL. The plane PL may be determined by the state of the angle adjustment joints 35, for example. The plane PL may be defined by theoperation section 8 b. To be specific, the angle of the plane PL along which thedisplay 3 is translated may be inputted from theoperation section 8 b. - In order to change the position and angle of the
display 3 more safely, thecontroller 61 may perform a control so that each joint is not unlocked while the operation handles 1 are being operated even if the pressing operation for the trigger levers 321 is detected. Whether the operation handles 1 are being operated can be detected with a motion sensor, for example. It is therefore possible to prohibit operating the operation handles 1 with one hand while operating thetrigger lever 321 with the other hand, improving the safety as medical equipment. - It is preferable that the
operation section 8 b (seeFIG. 4 ) is configured to set which to use among the above-described variations of the unlocking mechanism, that is, the condition to deactivate the locking mechanism of the joints by the trigger levers 321 as the unlocking mechanism. For example, the conditions are set as follows. - (1) Select one of the conditions: all the joints (the
joints 43 and parallel link mechanism 44) are unlocked when all the plural trigger levers 321 are subjected to unlocking operation or when at least any one of the plural trigger levers 321 is subjected to unlocking operation. - (2) When the trigger levers 321 are provided on the right and left of the
display 3 with space therebetween, set which to use among the trigger levers 321 for unlocking all the joints (for example, the right-handed or left-handed trigger lever) - (3) When the remote control apparatus includes plural trigger levers 321, set which joint to unlock by each trigger lever
- (4) Set the range where the
display 3 is movable (movable along only the plane parallel to the inclination of thedisplay 3, for example) - (5) When the remote control apparatus includes plural
display supporting arms 4, select adisplay 3 to be moved - It should be understood that the disclosed embodiments are shown by way of example in every respect and are not limitative. The scope of the invention is not determined by the aforementioned embodiments but is specified by Claims. The scope of the invention includes all alternations (modifications) within meanings and scope equivalent to the scope of Claims.
- The aforementioned first embodiment discloses an example(s) of the configuration in which one display supporting arm supporting the display is provided. The aforementioned second embodiment discloses an example(s) of the configuration in which two display supporting arms supporting the displays are provided. However, the invention is not limited to this example. For example, the remote control apparatus may be provided with three or more display supporting arms supporting displays, or the remote control apparatus may be provided with three or more displays.
- The aforementioned first and second embodiments disclose examples of the configurations in which each display supporting arm includes plural joints. However, the invention is not limited to this example. For example, the display supporting arm may include only one joint.
- The aforementioned first and second embodiments disclose examples of the configurations in which the displays are detachably attached to the display supporting arms. The invention is not limited to these examples. For example, the display may be fixed to the display supporting arm.
- The aforementioned second embodiment disclose examples of the configurations in which the remote control apparatus is provided with the scope and non-scope type displays. However, the invention is not limited to these examples. For example, the remote control apparatus may be provided with only one scope type display or may be provided with only one non-scope type display.
- The aforementioned first and second embodiments disclose examples of the configurations in which the mounted display is connected to the remote control apparatus with a cable so as to exchange information with the same. The invention is not limited to these examples. For example, the mounted display may be connected to the remote control apparatus through wireless communication so as to exchange information.
- The aforementioned first and second embodiments disclose examples of the configuration in which the supporting mechanism moves the operation handles and armrest up and down. However, the invention is not limited to these examples. For example, the supporting mechanism may move the operation handles and armrest in the horizontal direction in addition to up and down movements.
Claims (20)
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Also Published As
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CN109009447A (en) | 2018-12-18 |
US10653486B2 (en) | 2020-05-19 |
EP3412240A1 (en) | 2018-12-12 |
US10980604B2 (en) | 2021-04-20 |
CN109009447B (en) | 2022-05-06 |
US20200222125A1 (en) | 2020-07-16 |
JP2018202032A (en) | 2018-12-27 |
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